Instructions

HOW TO APPLY FOR FREE AND REDUCED
PRICE SCHOOL MEALS
Please use these instructions to help you fill out the application for free or reduced price school meals.
You only need to submit one application per household, even if your children attend more than one
school in [School District]. The application must be filled out completely to certify your children for free or
reduced price school meals.
Please follow these instructions in order! Each step of the instructions is the same as the steps on your
application. If at any time you are not sure what to do next, please contact [School/school district
contact here---phone & email preferred].
PLEASE USE A PEN (NOT A PENCIL) WHEN FILLING OUT THE APPLICATION AND DO YOUR BEST
TO PRINT CLEARLY.

STEP 1: LIST ALL

HOUSEHOLD MEMBERS WHO ARE INFANTS, CHILDREN, AND STUDENTS
UP TO AND INCLUDING GRADE 12
Tell us how many infants, children, and school students live in your household. They do NOT have to be
related to you to be a part of your household.

Who should I list here?
When filling out this section, please include all members in your household who are:
•
Children age 18 or under and are supported with the household’s income;
•
In your care under a foster arrangement, or qualify as homeless, migrant, or runaway
youth;
•
Students attending [school/school system here], regardless of age.
A) List each child’s name. For each child, print their first name, middle initial and last name. Use one
line of the application for each child. When printing names, write one letter in each box. Stop if you run
out of space. If there are more children present than lines on the application, attach a second piece of
paper with all required information for the additional children.
B) Is the child a student at [name of school/school system here]? Mark ‘Yes’ or ‘No’ under the
column titled “Student” to tell us which children attend [name of school/school district here].
C) Do you have any foster children? If any children listed are foster children, mark the “Foster Child”
box next to the child’s name. Foster children who live with you may count as members of your
household and should be listed on your application. If you are only applying for foster children, after
completing STEP 1, skip to STEP 4 of the application and these instructions.
D) Are any children homeless, migrant, or runaway? If you believe any child listed in this section
may meet this description, please mark the “Homeless, Migrant, Runaway” box next to the child’s name
and complete all steps of the application.

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How to Apply for School Meal Benefits| Application Instructions

STEP 2: DO

ANY HOUSEHOLD MEMBERS (INCLUDING YOU) CURRENTLY PARTICIPATE IN
ONE OR MORE OF THE FOLLOWING ASSISTANCE PROGRAMS: SNAP, TANF, OR FDPIR?

If anyone in your household participates in the assistance programs listed
below, your children are eligible for free school meals:
The Supplemental Nutrition Assistance Program (SNAP) or [insert State SNAP here]
Temporary Assistance for Needy Families (TANF) or [insert State TANF here]
The Food Distribution Program on Indian Reservations (FDPIR)

•
•
•

A) IF NO ONE IN YOUR HOUSEHOLD PARTICIPATES IN ANY OF THE ABOVE LISTED PROGRAMS:
•

Circle ‘NO’ and skip to STEP 3 on these instructions and STEP 3 on your application.

•

Leave STEP 2 blank.

B) IF ANYONE IN YOUR HOUSEHOLD PARTICIPATES IN ANY OF THE ABOVE LISTED PROGRAMS:
•

Circle ‘YES’ and provide a case number for SNAP, TANF, or FDPIR. You only need to write
one case number. If you participate in one of these programs and do not know your case number,
contact: [State/local agency contacts here]. You must provide a case number on your
application if you circled “YES”.

•

Skip to STEP 4.

STEP 3: REPORT INCOME FOR ALL

HOUSEHOLD MEMBERS

A) Report all income earned by children. Refer to the chart titled “Sources of Income for Children” in
these instructions and report the combined gross income for ALL children listed in Step 1 in your
household in the box marked “Total Child Income.” Only count foster children’s income if you are
applying for them together with the rest of your household. It is optional for the household to list foster
children living with them as part of the household.

What is Child Income?
Child income is money received from outside your household that is paid
directly to your children. Many households do not have any child income. Use
the chart below to determine if your household has child income to report.

Sources of Income for Children

•
•

Sources of Child Income
Earnings from work

•

Social Security
o Disability Payments
o Survivor’s Benefits

•

•

Income from persons outside the household

•

•

Income from any other source

•

2

•

Example(s)
A child has a job where they earn a salary
or wages.
A child is blind or disabled and receives
Social Security benefits.
A parent is disabled, retired, or deceased,
and their child receives social security
benefits.
A friend or extended family member
regularly gives a child spending money.
A child receives income from a private
pension fund, annuity, or trust.

How to Apply for School Meal Benefits| Application Instructions

FOR EACH ADULT HOUSEHOLD MEMBER:

Who should I list here?
When filling out this section, please include all members in your household who are:
•
Living with you and share income and expenses, even if not related and even if they do not
receive income of their own.
Do not include people who:
•
Live with you but are not supported by your household’s income and do not contribute
income to your household.
•
Children and students already listed in Step 1

How do I fill in the income amount and source?
FOR EACH TYPE OF INCOME:
•
Use the charts in this section to determine if your household has income to report.
•

Report all amounts in gross income ONLY. Report all income in whole dollars. Do not
include cents.
o Gross income is the total income received before taxes or deductions.
o Many people think of income as the amount they “take home” and not the total,
“gross” amount. Make sure that the income you report on this application has
NOT been reduced to pay for taxes, insurance premiums, or any other amounts
taken from your pay.

•

Write a “0” in any fields where there is no income to report. Any income fields left empty or
blank will be counted as zeroes. If you write ‘0’ or leave any fields blank, you are certifying
(promising) that there is no income to report. If local officials have known or available
information that your household income was reported incorrectly, your application will be
verified for cause.

•

Mark how often each type of income is received using the check boxes to the right of each
field.

B) List Adult Household member’s name. Print the name of each household member in the boxes
marked “Names of Adult Household Members (First and Last).” Do not list any household members you
listed in STEP 1. If a child listed in STEP 1 has income, follow the instructions in STEP 3, part A.
C) Report earnings from work. Refer to the chart titled “Sources of Income for Adults” in these
instructions and report all income from work in the “Earnings from Work” field on the application. This is
usually the money received from working at jobs. If you are a self-employed business or farm owner, you
will report your net income.

What if I am self-employed?
If you are self-employed, report income from that work as a net amount. This is
calculated by subtracting the total operating expenses of your business from its
gross receipts or revenue.
D) Report income from Public Assistance/Child Support/Alimony. Refer to the chart titled “Sources
of Income for Adults” in these instructions and report all income that applies in the “Public
Assistance/Child Support/Alimony” field on the application. Do not report the value of any cash value
public assistance benefits NOT listed on the chart. If income is received from child support or alimony,
only court-ordered payments should be reported here. Informal but regular payments should be reported
as “other” income in the next part.

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How to Apply for School Meal Benefits| Application Instructions

E) Report income from Pensions/Retirement/All other income. Refer to the chart titled “Sources of
Income for Adults” in these instructions and report all income that applies in the
“Pensions/Retirement/All Other Income” field on the application.
F) Report total household size. Enter the total number of household members in the field “Total
Household Members (Children and Adults).” This number MUST be equal to the number of household
members listed in STEP 1 and STEP 3. If there are any members of your household that you have not
listed on the application, go back and add them. It is very important to list all household members, as the
size of your household determines your income cutoff for free and reduced price meals.
G) Provide the last four digits of your Social Security Number. The household’s primary wage earner
or another adult household member must enter the last four digits of their Social Security Number in the
space provided. You are eligible to apply for benefits even if you do not have a Social Security
Number. If no adult household members have a Social Security Number, leave this space blank and mark
the box to the right labeled “Check if no SS#.”

Sources of Income for Adults

Earnings from Work
•
•
•

Salary, wages, cash
bonuses
Net income from selfemployment (farm or
business)
Strike benefits

If you are in the U.S. Military:
•
Basic pay and cash
bonuses (do NOT include
combat pay, FSSA or
privatized housing
allowances)
•
Allowances for off-base
housing, food, and
clothing

Public Assistance/Alimony/
Child Support
•
Unemployment benefits
•
Worker’s compensation
•
Supplemental Security
Income (SSI)
•
Cash assistance from
State or local government
•
Alimony payments
•
Child support payments
•
Veteran’s benefits

Pensions/Retirement/All Other
Income
•
Social Security (including
railroad retirement and
black lung benefits)
•
Private Pensions or
disability
•
Income from trusts or
estates
•
Annuities
•
Investment income
•
Earned interest
•
Rental income
•
Regular cash payments
from outside household

STEP 4: CONTACT INFORMATION AND ADULT SIGNATURE
All applications must be signed by an adult member of the household. By signing the application,
that household member is promising that all information has been truthfully and completely reported.
Before completing this section, please also make sure you have read the privacy and civil rights
statements on the back of the application.
A) Provide your contact information. Write your current address in the fields provided if this
information is available. If you have no permanent address, this does not make your children
ineligible for free or reduced price school meals. Sharing a phone number, email address, or both is
optional, but helps us reach you quickly if we need to contact you.
B) Sign and print your name. Print your name in the box “Printed name of adult completing the form.”
And sign your name in the box “Signature of adult completing the form.”
C) Write Today’s Date. In the space provided, write today’s date in the box.
D) Share children’s Racial and Ethnic Identities (optional). On the back of the application, we ask
you to share information about your children’s race and ethnicity. This field is optional and does not
affect your children’s eligibility for free or reduced price school meals.

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How to Apply for School Meal Benefits| Application Instructions