Admin

Free and Reduced Application


Beginning July 5, 2022, all free and reduced lunch applications will be submitted via MySchoolApps.com. If you need assistance, please call the Business Office at 307-358-2942 option 1 or stop by to complete an application at 
615 Hamilton St Douglas, WY



 

 

LETTER TO HOUSEHOLD 2022-2023

 

Dear Parent/Guardian:

 

Children need healthy meals to learn. Converse County School District #1 offers healthy meals every school day. DPS, DIS and DUES Breakfast costs $1.45 ; lunch costs $3.15. DMS and DHS Breakfast costs $1.50 ; lunch costs $3.45. Your children may qualify for free meals or for reduced price meals. Reduced price is .30 for breakfast and .40 for lunch. This packet includes an application for free or reduced price meal benefits, and a set of detailed instructions. Below are some common questions and answers to help you with the application process.

 

1. WHO CAN GET FREE OR REDUCED PRICE MEALS?

●     All children in households receiving benefits from SNAP, The Food Distribution Program on Indian Reservations (FDPIR) or TANF (Temporary Assistance for Needy Families), are eligible for free meals.

●     Foster children that are under the legal responsibility of a foster care agency or court are eligible for free meals. Whether placed by the State child welfare agency or a court, in order for a child to be considered categorically eligible for free meals, the State must retain legal custody of the child.

●     Children participating in their school’s Head Start program are eligible for free meals. ●        Children who meet the definition of homeless, runaway, or migrant are eligible for

free meals.

●     Children may receive free or reduced price meals if your households income is within the limits on the Federal Income Eligibility Guidelines. Your children may qualify for free or reduced price meals if your household income falls at or below the limits on this chart.

 

FEDERAL ELIGIBILITY INCOME CHART For School Year 2022-2023

Household size

Yearly

Monthly

Weekly

1

$25,142

$2,096

$484

2

$33,874

$2,823

$652

3

$42,606

$3,551

$820

4

$51,338

$4,279

$988

5

$60,070

$5,006

$1,156

6

$68,802

$5,734

$1,324

7

$77,534

$6,462

$1,492

8

$86,266

$7,189

$1,659

Each additional person:

$8,732

$728

$168

 

2. HOW DO I KNOW IF MY CHILDREN QUALIFY AS HOMELESS, MIGRANT, OR RUNAWAY? Do the members of your household lack a permanent address? Are you staying together in a shelter, hotel, or other temporary housing arrangement? Does your family relocate on a seasonal basis? Are any children living with you who have chosen to leave their prior family or household? If you believe children in your household meet these descriptions and haven’t been told your children will get free meals, please call or email Penny Bolinger 307-358-4874 pbolinger@ccsd1.org


 

 

3. DO I NEED TO FILL OUT AN APPLICATION FOR EACH CHILD? No. Use one Free and Reduced Price School Meals Application for all students in your household. We cannot approve an application that is not complete, so be sure to fill out all required information. Return the completed application to: CCSD#1 Business Office, 615 Hamilton St Douglas, WY 82633, 307-358-2942 businessoffice@ccsd1.org.

 

4. SHOULD I FILL OUT AN APPLICATION IF I RECEIVED A LETTER THIS SCHOOL YEAR SAYING MY CHILDREN ARE ALREADY APPROVED FOR FREE MEALS? No, but please read the letter you got carefully and follow the instructions. If any children in your household were missing from your eligibility notification, contact CCSD#1 Business Office, 615 Hamilton St Douglas, WY 82633, 307-358-2942 businessoffice@ccsd1.org immediately.

 

5. CAN I APPLY ONLINE? Yes! You are encouraged to complete an online application instead of a paper application if you are able. The online application has the same requirements and will ask you for the same information as the paper application. Visit myschoolapps.com to begin or to learn more about the online application process. Contact CCSD#1 Business Office, 615 Hamilton St Douglas, WY 82633, 307-358-2942 businessoffice@ccsd1.org if you have any questions about the online application.

 

6. MY CHILDS APPLICATION WAS APPROVED LAST YEAR. DO I NEED TO FILL OUT A NEW ONE? Yes. Your childs application is only good for that school year and for the first few days of this school year, through October 4, 2022. You must send in a new application unless the school told you that your child is eligible for the new school year. If you do not send in a new application that is approved by the school or you have not been notified that your child is eligible for free meals, your child will be charged the full price for meals.

 

7. I GET WIC. CAN MY CHILDREN GET FREE MEALS? Children in households participating in WIC may be eligible for free or reduced price meals. Please send in an application.

 

8. WILL THE INFORMATION I GIVE BE CHECKED? Yes. We may also ask you to send written proof of the household income you report.

 

9. IF I DON’T QUALIFY NOW, MAY I APPLY LATER? Yes, you may apply at any time during the school year. For example, children with a parent or guardian who becomes unemployed may become eligible for free and reduced price meals if the household income drops below the income limit.

 

10. WHAT IF I DISAGREE WITH THE SCHOOLS DECISION ABOUT MY APPLICATION? You should talk to school officials. You also may ask for a hearing by calling or writing to: Brian Bartz, 615 Hamilton St Douglas, WY 82633, 307-358-2942 bbartz@ccsd1.org.

 

11. MAY I APPLY IF SOMEONE IN MY HOUSEHOLD IS NOT A U.S. CITIZEN? Yes. You, your children, or other household members do not have to be U.S. citizens to apply for free or reduced price meals.

12. WHAT IF MY INCOME IS NOT ALWAYS THE SAME? List the amount that you normally receive. For example, if you normally make $1000 each month, but you missed some work last month and only made $900, put down that you made $1000 per month. If you normally get overtime, include it, but do not include it if you only work overtime sometimes. If you have lost a job or had your hours or wages reduced, use your current income.


 

13. WHAT IF SOME HOUSEHOLD MEMBERS HAVE NO INCOME TO REPORT? Household members may not receive some types of income we ask you to report on the application, or may not receive income at all. Whenever this happens, please write a 0 in the field. However, if any income fields are left empty or blank, those will also be counted as zeroes. Please be careful when leaving income fields blank, as we will assume you meant to do so.

 

14. WE ARE IN THE MILITARY. DO WE REPORT OUR INCOME DIFFERENTLY? Your basic pay and cash bonuses must be reported as income. If you get any cash value allowances for off-base housing, food, or clothing, it must also be included as income. However, if your housing is part of the Military Housing Privatization Initiative, do not include your housing allowance as income. Any additional combat pay resulting from deployment is also excluded from income.

 

15. WHAT IF THERE ISN’T ENOUGH SPACE ON THE APPLICATION FOR MY FAMILY? List any additional household members on a separate piece of paper, and attach it to your application. Contact CCSD#1 Business Office, 615 Hamilton St Douglas, WY 82633, 307-358-2942 businessoffice@ccsd1.org to receive a second application.

 

16. MY FAMILY NEEDS MORE HELP. ARE THERE OTHER PROGRAMS WE MIGHT APPLY FOR? To find out how to apply for SNAP or other assistance benefits, contact your local assistance office or call 307-777-7564. If you have other questions or need help, call 307-358-2942.

 

Sincerely,

 

Brian Bartz, Business Manager

 

 

 

 

Non-Discrimination Statement: This explains what to do if you believe you have been treated unfairly.

 

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

 

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

 

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

 

1.     mail:

U.S. Department of Agriculture

Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW

Washington, D.C. 20250-9410; or

2.     fax: (833) 256-1665 or (202) 690-7442; or 3.        email: program.intake@usda.gov

 

This institution is an equal opportunity provider.


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 and 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 childs name. Print each child’s           B) Is the child a student at [name       C) Do you have any foster children? If any children name. Use one line of the application for each                                                          of school/school system here]?            listed are foster children, mark the “Foster Child”

child. When printing names, write one letter in     Mark Yes’ or No’ under the                 box next to the child’s name. If you are ONLY

each box. Stop if you run out of space. If there      column titled “Student” to tell us        applying for foster children, after finishing STEP 1, are more children present than lines on the

application, attach a second piece of paper           school/school district here]. If you      Foster children who live with you may count as marked ‘Yes,’ write the grade level members of your household and should be listed on of the student in the ‘Gradeyour application. If you are applying for both foster column to the right.                     and non‐foster children, go to step 3.

STEP 2: DO ANY HOUSEHOLD MEMBERS CURRENTLY PARTICIPATE IN SNAP, TANF, OR FDPIR?


 

 

 

 

D) Are any children homeless, migrant, or runaway? If you believe any child listed in this section meets this description, mark the “Homeless, Migrant, Runaway” box next to the child’s name and complete all steps of the application.


If anyone in your household (including you) currently participates in one or more of 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      B) If anyone in your household participates in any of the above listed programs:

listed programs:                                                                                            ·      Write a case number for SNAP, TANF, or FDPIR. You only need to provide one case number. If you participate ·                         Leave STEP 2 blank and go to STEP 3.                                                       in one of these programs and do not know your case number, contact: [State/local agency contacts here].

·      Go to STEP 4.

STEP 3: REPORT INCOME FOR ALL HOUSEHOLD MEMBERS How do I report my income?

·      Use the charts titled Sources of Income for Adults and Sources of Income for Children,” printed on the back side of the application form 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.

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


STEP 3: REPORT INCOME FOR ALL HOUSEHOLD MEMBERS

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 also be counted as a zero. If you write ‘0’ or leave any fields blank, you are certifying (promising) that there is no income to report. If local officials suspect that your household income was reported incorrectly, your application will be investigated.

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

3.A. REPORT INCOME EARNED BY CHILDREN

A) Report all income earned or received by children. Report the combined gross income for ALL children listed in STEP 1 in your household in the box marked “Child Income.” Only count foster children’s income if you are applying for them together with the rest of your 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.

3.B REPORT INCOME EARNED BY ADULTS

Who should I list here?

· When filling out this section, please include ALL adult members in your household who are living with you and share income and expenses, even if they are not related and even if they do not receive income of their own.

· Do NOT include:

o People who live with you but are not supported by your household’s income AND do not contribute income to your household. o Infants, Children and students already listed in STEP 1.

B) List adult household members’ names. 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. 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? 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. Report all income that applies in the “Public Assistance/Child Support/Alimony” field on the application. Do not report the cash value of any public assistance benefits NOT listed on the chart. If income is received from child support or alimony, only report court‐ordered payments. Informal but regular payments should be reported as “other” income in the next part.

E) Report income from pensions/retirement/all other income. 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 affects your eligibility for free and reduced price meals.

G) Provide the last four digits of your Social Security Number. An 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 SSN.”

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) Print and sign your name and write todays date. Print the name of the adult signing the application and that person signs in the box “Signature of adult.”

C) Mail Comple

ted

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.

Form to:

Inser

t

 

School/District

 

address here

 

 


2022-2023 Household Application for Free and Reduced Price School Meals                                                                                                                                                                    Apply online at: myschoolapps.com Complete one application per household. Please use a pen (not a pencil).Text Box: Check all that apply

 

STEP 1

 

List ALL Household Members who are infants, children, and students up to and including grade 12 (if more spaces are required for additional names, attach another sheet of paper)

 


 

Definition of Household          Child’s First Name                                                      MI     Child’s Last Name                                          Grade Member: “Anyone who is

living with you and shares income and expenses, even if not related.”

 

Children in Foster care and children who meet the definition of Homeless, Migrant or Runaway are eligible for free meals. Read How to Apply for Free and Reduced Price School Meals for more information.


 

Student?

Yes         No


Homeless, Foster     Migrant,

Child     Runaway


 

STEP 2

 

Do any Household Members (including you) currently participate in one or more of the following assistance programs: SNAP, TANF, or FDPIR?

 

If NO       > Go toSTEP 3.                If YES > Write a case number here then go to STEP 4 (Do not complete STEP 3)               Case Number:

Write only one case number in this space.

 

STEP 3

Report Income for ALL Household Members (Skip this step if you answered Yes’ to