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Free and Reduced Price School Meals Family Application (fr_FreeReducedFamApp)


The Free and Reduced Price School Meals Family Application form is used by local education agencies as the family and/or student application form for the National School Lunch Program and School Breakfast Program, when they use paper forms. The form may also be used for the Child and Adult Care Food Program and the Summer School Food Service Program when an individual child's eligibility must be established. (NOTE: Direct certification is used to determine that children are eligible for free benefits based on documentation directly through an appropriate state or local agency, for children who are: 1) members of a Food Stamp household or are members of a houshold receiving assistance under FDPIR or under TANF; or 2) homeless, migrant, runaway, or Head Start/Even Start children.)

Data Set Items

    All Other Income Amount - All other income amount for a person in household.

Amount of Gross Earnings from Work Before Deductions - The gross amount of earnings from work for a person in the household before deductions.

Amount of Personal Use Monthly Income for Foster Child - Amount of personal use monthly income for foster child.

Ethnic Identity of Children - Ethnic identity of children.

Code Set:

  • Hispanic or Latino
  • Not Hispanic or Latino

FDPIR Case Number for Child - Food Distribution Program on Indian Reservations (FDPIR) case number for child.

FoodShare Case Number for Child - FoodShare case number for child.

Grade - Grade of child in school.

Name of Child in School - Name of child in school (first, middle initial, last).

Name of Person in Household - Name of person in household.

No Income Selection - No income selection for a person in household.

No Social Security Number Selection - No Social Security Number selection for adult household member.

Racial Identity of Children - Children's racial identities (optional) - Choose one or more.

Code Set:

  • American Indian or Alaska Native
  • Asian
  • Native Hawaiian or Other Pacific Islander
  • Other
  • White

Retirement, Social Security Income Amount - Pensions, retirement, Social Security income amount for a person in household.

School Name - Name of school that child attends.

Signature of Adult Household Member - Signature of adult household member.

Social Security Number of Adult Household Member - Social Security Number of adult household member.

Status of Child as Foster Child - Foster child selection for child.

Status of Child as Homeless - Status of Child as Homeless.

Status of child as migrant - Status of Child as Migrant.

Status of Child as Runaway - Status of Child as Runaway.

Timeframe for Gross Income - Period for which gross income is reported for a person in household.

W-2 Cash Benefits Case Number for Child - W-2 Cash Benefits case number for child.

Welfare, Child Support, Alimony Income Amount - Welfare, child support, alimony income amount for a person in household.