INSTRUCTIONS FOR COMPLETING THE WEB BASED HOUSEHOLD APPLICATION
FOR FREE AND REDUCED PRICE MEALS

To apply for free or reduced price meals, complete one application for ALL children in the household who are in enrolled in Spokane Public Schools.  Call 509-354-7270 if you need assistance.

Follow these steps as you complete you application on line.  The program will provide prompts to assist you in providing the required information.

Part 1 – Households With a Foster Child
If this application is for a foster child, check the box in the far right portion of this section.  You may only include on foster child per application.  If you household includes multiple foster children, please complete one application for each foster child.
A foster child is the legal responsibility of a welfare agency or court.

1. List the foster child’s monthly “personal use” income.  Indicate “0” if the foster child does not get “personal use” income.  “Personal use” income is money given by the welfare office identified by category for the child’s personal use, such as far clothing, school fees, and allowances; and all other money the child receives.
2. You will notice that required fields will appear white wile fields that are not required will appear gray.  Please complete all required fields.

Part 2 – Student Information

1. Complete the requested date for all children in your household who attend Spokane Public School District.
2. Type the student’s date of birth and exact spelling of the first and last name as they appear on the student’s school records.  Hit “find student ID” button.  You will not be able to see if the student is found, but if it isn’t found, the Nutrition Services office will fill in the appropriate ID number.
3. If the student or students receive Basic Food or TANF, mark the appropriate box.  List the current basic food or TANF case number for each child.  This number is on your approval letter from DSHS.  You will notice that required fields will appear white while fields that are not required will appear gray.  Please complete all required fields.

Part 3 – Parent/Guardian Name and Social Security Number

1. The fields that are required for a complete application are white.  You must fill in all information that is highlighted in white on the application.
2. If you do not have a social security number you must indicate so by checking the box marked “I do not have a SSN.”

Part 4 – Total Household Income
Fields in this section will appear grey if they are not required based on the information you provided in the sections above.

1. If not already listed, type the names of everyone in your household, whether they get income or not.  Included yourself, all children, your spouse, parents, grandparents and other related and unrelated people in your household.
2. Type the amount of income each household member gross (before taxes or other deductions are taken out) income. 
3. Indicate how often the income is received by selecting an income frequency.  Select (W) for weekly, (E) for every two weeks, (T) for twice a month and (M) for monthly.
4. Other benefits and racial/ethnic information is optional.

Part 5 – Approval and Signature

1. You must read each of the statements below and indicate your acceptance of them by clicking the “Agree” button in the left.  If you select “Decline” on either statement, your application will not be processed.
2. After accepting each of the statements, click in the “Guardian Signature” box.  Your name will appear with today’s date and time.  Then select “Submit” from the drop down on the right and click the “Go” button.
3. You will receive an application number for reference purposes and an estimated processing time.

*Privacy Act Statement:  National School Lunch Act (Section 9) - requires that, unless your child's Basic Food, TANF, or FDPIR case number is provided, you must include the social security number of the adult household member signing the application or indicate that the household member signing the application does not have a social security number.  Provision of a social security number is not mandatory, but if a social security number is not given or an indication is not made that the signer does not have such a number, the application cannot be approved.  The social security number may be used to identify the household member in carrying out efforts to verify the correctness of information stated on the application.  These verification efforts may be carried out through program reviews, audits, and investigations and may include contacting employers to determine income, benefits, contacting the State employment security office to determine the amount of benefits received and checking the documentation produced by household members to prove the amount of income received.  These efforts may result in a loss or reduction of benefits, administrative claims or legal actions if incorrect information is reported.

NONDISCRIMINATION
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, sex, or disability.  Persons with disabilities who require alternative means for communications of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (209) 720-2600 (voice and TDD).

To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue SW, Washington, DC 20250-9410 or call (800) 795-3272 or (202) 720-6382 (TDD).  USDA is an equal opportunity provider and employer.

INCOME CHART
Effective From July 1, 2008 to June 30, 2009

Household Size

Yearly Income

Monthly Income

Weekly Income

1

$19,240

$1,604

$  370

2

$25,900

$2,159

$  499

3

$32,560

$2,714

$  627

4

$39,220

$3,269

$  755

5

$45,880

$3,824

$  883

6

$52,540

$4,379

$1,011

7

$59,200

$4,934

$1,139

8

$65,860

$5,489

$1,267

Each Additional Member Add:

+ $6,660

+ $555

+ $129