Free & Reduced Meal Benefits

Dear Parent/Guardian:
Suffolk City Public Schools serve nutritious meals every day. Students may purchase breakfast for sixty five (.65) cents. Elementary students may buy lunch for one dollar and twenty ($1.20) cents. Middle and high school students may buy lunch for one dollar and thirty-five ($1.35) cents. Children from families whose income is at or below the level shown on the scale below may be eligible for meals free or at the reduced prices of forty (.40) cents for lunch and thirty (.30) cents for breakfast. Students may pre-pay for meals weekly or monthly. All meals served must meet standards established by the U.S. Department of Agriculture. However, if a child (ren) has been determined by a doctor to be disabled and the disability prevents the child (ren) from eating the regular school meal, the school will consider substitutions prescribed by the doctor. If a substitution is prescribed, there will be no extra charge for the meal. If your child (ren) needs substitutions because of a disability, please get in touch with us for further information.
Before applying, refer to this chart, which lists the maximum family income allowed to qualify for reduced price meal.

INCOME CHART
Effective July 1, 2005 to June30,2006
Household Size	Annual	Monthly	Every Two Weeks	Weekly
1	17,705	1,476	681	341
2	23,736	1,978	913	457
3	29,767	2,481	1,145	573
4	35,798	2,984	1,377	689
5	41,829	3,486	1,609	805
6	47,860	3,989	1,841	921
7	53,891	4,491	2,073	1,037
8	59,922	4,994	2,305	1,153
For Each Additional Family Member Add	6,031	503	232	116

To apply for free or reduced price meals, complete the application as soon as possible, sign it, and return it to the school.

Homeless, Migrant or Runaway:  If the child (ren) you are applying for is a homeless, migrant or runaway check the box and call your school Director of Guidance Coordinator for assistance. Fill out the application by following instructions for ALL OTHER HOUSEHOLDS section #4 of the application.

FOSTER CHILDREN:  If you have foster children living with you, who are the legal responsibility of the courts or welfare agency, they may be eligible for these benefits.  If you wish to apply for them, please complete the application, (part 3) and sign the application in section #6.

FOOD STAMP/VA TANF (AFDC) HOUSEHOLDS:  Households that are receiving food stamps or TANF for their children may not have to fill out an application. School officials will notify you of your child (ren)’s eligibility and they will be provided free benefits, unless you tell the school that you do not want benefits. If you are not notified by (August 11, 2006), you must submit an application. The application must contain the child’s name, the food stamp or TANF number, and the signature of an adult household member.

ALL OTHER HOUSEHOLDS: Children who are members of households participating in WIC may also be eligible for free or reduced-price meals based on the household’s income. To apply, carefully complete the application and return it to your school or mail to the address on the back of this form.  If you do not list a food stamp or VA TANF case number for the child (ren) you are applying for, then the application must have the child (ren) name, the names of all household members, and the amount and frequency of income (before deduction for taxes, social security, etc.) each person received last month.  An adult household member must sign the application and include his/her social security number.  If he/she does not have a social security number, you must check in the box provided in section #6 of the application.

OTHER BENEFITS: Your child (ren) may be eligible for other benefits such as the Virginia children’s health insurance program and Medicaid.  The law now allows the school division to share your free or reduced price meal eligibility information with Medicaid and the Virginia children's health insurance program called Family Access to Medical Insurance Security (FAMIS).  Medicaid and FAMIS can only use the information to identify children who may be eligible for free or low-cost health insurance, and to enroll them in either Medicaid or the Virginia children's health insurance program.  These agencies are not allowed to use the information from your free or reduced price meal application for any other purpose.  Medicaid officials or officials with the children’s health insurance program may contact you to get more information.  You are not required to allow us to share this information with Medicaid or the FAMIS program.  Your decision will not affect your children's eligibility for free and reduced price meals.  (See part #5 of application)

CONFIDENTIALITY AND NOTICE OF DISCLOSURE: School officials use the information on the application to determine if your child (ren) is eligible to receive free or reduced price meals and to verify eligibility.  As authorized by the National School Lunch Act, the school division may inform officials connected with other child (ren) nutrition, health, and education programs of the information on your application to determine benefits for those programs or for funding and/or evaluation purposes.

VERIFICATION: School officials may check you eligibility at any time during the school year. School officials may ask you to send information to prove that your child (ren) should receive free or reduced price meals.

FAIR HEARING:  If you do not agree with the decision of the school on your application or the results of verification, you may wish to discuss it with Food & Nutrition Services.  You also have the right to a fair hearing.  This can be done by calling or writing Brian K. Williams, Supervisor, Food & Nutrition Services, 119 Forest Glen Drive, Suffolk, Virginia 23439, 925-5570.

REAPPLICATION: You may reapply for benefits at any time during the school year. If you are not eligible now but have a change, such as a decrease in household income, an increase in household size, become unemployed or get food stamps or VA TANF for your child (ren), fill out an application at that time.

If you have any questions or need help in filling out the application, please contact Loretta Ellis, Food & Nutrition Services Secretary.  119 Forest Glen Drive, Suffolk, VA 23434, 925-5789.  You will be notified when the application is approved or denied.

                                                                                                                                                 Sincerely,

                                                                                                                                                 Brian K. Williams

                                                                                                                                                 Supervisor, Food & Nutrition Service

In accordance with Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discriminating on the basis of race, color, national origin, sex, age, or disability.  To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400 Independence Avenue SW, Washington, DC 20250-9410 or call (202) 720-5964 (voice and TDD).  USDA is an equal opportunity provider and employer.

A NEW APPLICATION MUST BE FILLED OUT EVERY SCHOOL YEAR. YOU MUST PAY FULL PRICE UNTIL THIS APPLICATION IS APPROVED.