• Millions of students participate in the National School Lunch Program every day. These benefits are from the federal government.
• Free and reduced price benefits are available to us from the Federal Government. We welcome applications at any time during the school year. If you think you may qualify, please fill out the appropriate form. Applications are sent home with every student at the beginning of the school year, generally on the first day of instruction. They are available in your school cafeteria and your school office, as well.
• Family finances are a very personal matter and your application will be handled with confidentiality and respect. If you think you may qualify for, please complete an application.
• We welcome applications at any time during the school year, however,
• If you qualified last year for meal benefits, you must reapply this year by September 22th to continue benefits for the 2008-09 school year. Please complete and return an application ASAP to avoid an interruption in service for your child.
• Send completed applications, sealed in an envelope, to Sara Simmerman, Food Service Director, to school or to 7714 Ann Arbor Street, Dexter, MI 48130

AUGUST -2009

Dear Parent or Guardian:

Children need healthy meals to learn. The Dexter Community Schools offer healthy meals every school day. Students may buy lunch for $2.25 and $2.50, and breakfast for $1.25 and $1.50. Your children may qualify for free meals or reduced price meals. We will sell reduced price meals for $ .40 and breakfasts for $ .30. If a doctor has determined that your child has a disability, and the disability would prevent the child from eating the regular school meal, the school will make any substitution prescribed by a doctor at no extra charge. For further information, please call S.Simmerman, 734-424-4100, ext. 1501. The doctor's statement, including prescribed diet and/or substitution, must be submitted to the food service department at your school.

• Do I need to fill out an application for each child? No. Complete the application to apply for free and reduced price meals. Use one Free and Reduced Price School Meals Family 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 DCS F&N Services, Sara Simmerman , Director, 7714 Ann Arbor Street, Dexter, MI, 48130 (734) 424-4100 Et. 1501.
  
• Who can get free meals? Children in households getting Supplemental Nutrition Assistance Program (SNAP) benefits (formerly the Food Stamp Program), getting TANF and most foster children can get free meals regardless of your income. Also, your children can get free meals if your household income is within the free limits of the Federal Income Guidelines.
  
• Can homeless, runaway and migrant children get free meals? Please call Rob Glass, Superintendent, Homeless Liaison/Migrant Coordinator, at (734) 424-4100 Ext. 1001, to see if your child(ren) qualify, if you have not been informed that they will get free meals.
  
• Who can get reduced price meals? Your children can get free meals if your household income is within the reduced price limits of the Federal Income Chart, shown on this application.
  
• Should I fill out an application if I get a letter this school year saying my children are approved for free or reduced price meals? Please read the letter you got carefully and follow the instructions. Call the School at (734) 424-4100 Et. 1501, if you have questions.
  
• I get WIC. Can my child(ren) get free meals? Children participating in WIC may be eligible for free or reduced price meals. Please fill out an application.
  
• Will the information I give be checked? Yes, we may ask you to send written proof.
  
• If I don't qualify now, may I apply later? You may apply at any time during the school year if your household size goes up, income goes down, or if you start receiving SNAP or getting TANF, or other benefits. If you lose your job, your children may be able to get free or reduced price meals.
  
• What if I disagree with the school's decision about my application? You should talk to school officials. You may also ask for a hearing by calling or writing to DCS, Rob Glass, Superintendent, 7714 Ann Arbor Street, Dexter, MI, 48130, (734) 424-4100 Ext. 1001.
  
• May I apply if someone in my household is not a U.S. Citizen? Yes. You or your child(ren) do not have to be a U.S. citizen to qualify for free or reduced price meals.
  
• Who should I include as member of my household? You must include all people living in your household, related or not, (such as grandparents, other relatives or friends). You must include yourself and all children who live with you.
  
• What if my income is not always the same? List the amount you normally get. For example, if you normally get $1000 per month, but you missed some work last month and only get $900, put down that you get $1000 per month. If you normally get overtime, include it, but not if you only get it sometimes.
  
• We are in the military; do we include our housing allowance as income? If your housing is part of Military Privatization Initiative, do not include your housing as income. All other allowances must be included in your gross income.
  
• What if my child does not have health insurance? Your children may qualify for low cost or free health insurance through MIChild and Healthy Kids Program. To apply on-line, go to www.michigan.gov/michild or call 1-888-988-6300 for help or to request a paper application.
  

If you have other questions or need help, call (734)424-4100 Ext. 1501

Sincerely,

Sara Simmerman, DCS F&N Services

______________________________________________________________________________________________________

Privacy Act Statement: This ex[laians how e 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 Social Security Number of the adult household member who signs the application. 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 chld 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 eligibile for free or reduced price meals and for adminstration 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 programs, auditors for program reveiws 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 the Federal law and U.S. Department of Agriculture policy, this institution is prohibited from discrimination on the basis of race, color, national origin, sex, age, or disability. To file a commplaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410 or call (800) 795-3272 or (202) 720-6382 (TTY). USDA is an equal opportunity provider and employer."

If your household receives benefits from the Supplemental Assistance Program (SNAP), formerly the Food Stamp Program, or gets TANF, follow these instructionsFOOD STAMPS, FIP or FDPIR, follow these instructions:

Part 1: List child(ren)'s names, school, grade and a SNAP or TANF case number
Part 2: Check the appropriate box ,if any.
Part 3: Skip this part
Part 4: Skip this part
Part 5: Sign the form. A Social Security Number is not necessary.
Part 6: Answer this question if you choose to.

If applying for homeless, migrant or runaway, check the appropriate box and contact DCS, Rob Glass , Superintendent, Homeless Liaison /Migrant Coordinator, 7714 Ann Arbor Street, Dexter, MI 48130. Phone 734-424-4100 ext 1001. Fill out application by following instructions for ALL OTHER HOUSEHOLDS.

If you are applying for a FOSTER CHILD, follow these instructions:
Part 1: Use a separte application for each foster child. List the child's name, school, grade.
Part 2: Skip this part.
Part 3: Check the box and list the child's personal use monthly income, if any.
Part 4: Skip this part.
Part 5: Sign the form. A Social Security Number is not necessary.
Part 6: Answer this question if you choose to.

ALL OTHER HOUSEHOLDS, including WIC households, follow these instructions:
Part 1: List each child's name, school, grade.
Part 2: Check the appropriate box, if any.
Part 3: Skip this part.
Part 4: Follow these instructions to report total month income from last month.
Column 1 - Name:

• List the first and last name of each person living in your household, related or not (such as grand parents, other relative or friends) You must include yourself and all children living with you. Attach another sheet of paper if you need to.

Column 2 - Gross Income and how often it was received

• Next to each person's first and last names list each type of income received last month and how often it was received.. For example,
  +Earnings from work: List the gross income each person earned from work. This is not the same as take home pay. Gross income is the amount earned before taxes and other deductions. The amount should be listed on your pay stub or your boss can tell you. Next to the amount write how often the oerson git it (weekly, twice a month, monthly)
  +All other income: List the amount each person got last month from welfare, child support, and alimony, (second column), pensions, retirement, Social Security (third column ), and ALL OTHER INCOME SOURCES (fourth column). In the All Other column, include Worker's Compensation, unemployment, strike benefits, Supplemental Security (SSI), Veteran's benefits (VA benefits), disability benefits, regular contributions from people who do not live in your household and ANY OTHER INCOME. Report net income from anself-owned business, farm or rental income. Next tot eh amount write how often eht person got it. If you are in the Military Privatization Initiative, do not include this housing allowance.
  +If the person does not have any income, circle "NO" in the last column "Circle if NO income."

Column 3-Check if no income:

• If the person does not have any income, check the box ."I do not have a social security number." if he or she does not have one.

Part 5: An adult househld member must sign the form and list his or her Social Security Number, or mark the box if he or she does not have one.
Part 6: Answer this question if you choose to.

• Use the link below to go to meal application: