PA School Meals
Apply for 2016-2017
HOW TO APPLY FOR FREE AND REDUCED PRICE SCHOOL MEALS
Please use these instructions to help you fill out the online 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 Octorara Area 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 Linda Neff at 610-593-8238 ext 3581.
The online application can be found at www.paschoolmeals.com.
STEP 1: LIST ALL CHILDREN IN SCHOOL IN THE HOUSEHOLD.
Tell us how many children in school live in your household. They do NOT have to be related to you to be a part of your household. All children attending school must be listed.
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, runaway, or Head Start.
A) List each student’s name. Print each child’s 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.
B) Do you have any foster children? If any children listed are foster children, mark the “Foster Child” box next to the child’s name. If you are ONLY applying for foster children, after finishing STEP 1, go to STEP 4. Foster children who live with you may count as members of your household and should be listed on your application. If you are applying for both foster and non-foster children, go to step 3.
C) Are any children homeless, migrant, runaway, or Head Start? If you believe any child listed in this section meets this description, mark the corresponding box next to the child’s name and complete all steps of the application.
STEP 2: DO ANY HOUSEHOLD MEMBERS (INCLUDING YOU) CURRENTLY PARTICIPATE IN ONE OR MORE OF THE FOLLOWING ASSISTANCE PROGRAMS: SUPPLEMENTAL NUTRITION PROGRAM (SNAP) OR TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF)?
A) IF NO ONE IN YOUR HOUSEHOLD PARTICIPATES IN ANY OF THE ABOVE LISTED PROGRAMS: Circle ‘NO’ and proceed to STEP 3 on these instructions and STEP 3 on your application.
B) IF ANYONE IN YOUR HOUSEHOLD PARTICIPATES IN ANY OF THE ABOVE LISTED PROGRAMS: Circle ‘YES’ and provide the case number. You only need to write one case number. If you participate in one of these programs and do not know your case number, contact your local assistance office. 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 (EVEN IF THEY DO NOT RECEIVE INCOME).
A) LIST ALL HOUSEHOLD MEMBERS (including yourself and students listed in Part 1) 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 people who live with you but are not supported by your household’s income AND do not contribute income to your household.
B) REPORT TOTAL INCOME for each household member listed for each source provided. Report all income in whole dollars. Do not include cents. If they do not receive income from any source, write “0”. If you write “0” or leave any income fields blank, you are certifying (promising) that there is no income to report. Mark how often each type of income is received by using the boxes to the right of each field.
- Report all amounts in GROSS INCOME ONLY. Gross income is the total income received before taxes; 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.
- 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.
C) REPORT TOTAL HOUSEHOLD SIZE. Enter the total number of household members in the field “Total Household Size (Children and Adults).” This number MUST be equal to the number of household members listed in 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.
D) PROVIDE THE LAST FOUR DIGITS OF YOUR SOCIAL SECURITY NUMBER. The household’s primary wage earner or another adult household member must provide the last four digits of his/her 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 at the bottom of these instructions.
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) ELECTRONICALLY SIGN YOUR APPLICATION.
C) TYPE IN TODAY’S DATE. In the space provided, type today’s date in the box.
D) SHARE CHILDREN’S RACIAL AND ETHNIC IDENTITIES (OPTIONAL). At the bottom 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.
Privacy Act Statement: This explains how we will use the information you give us.
The Richard B. Russell National School Lunch Act requires the information on this application. You do not have to give the information, but if you do not, we cannot approve your child for free or reduced price meals. You must
include the last four digits of the social security number of the adult household member who signs the application. The last four digits of the social security number is not required when you apply on behalf of a foster child or you list a
Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) Program or Food Distribution Program on Indian Reservations (FDPIR) case number or other FDPIR identifier for your child or
when you indicate that the adult household member signing the application does not have a social security number. We will use your information to determine if your child is eligible for free or reduced price meals, and for
administration and enforcement of the lunch and breakfast programs. We MAY share your eligibility information with education, health, and nutrition programs to help them evaluate, fund, or determine benefits for their programs,
auditors for program reviews, and law enforcement officials to help them look into violations of program rules.
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, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA
programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived
from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing
deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET
Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed
to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter 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; (2) fax: (202) 690-7442; or (3) email: email@example.com.
USDA is an equal opportunity provider, employer, and lender.