Household Applications

SSO Templates and Resources	Household Applications	Application Verification	Area Eligibility	Income Eligibility Guidelines	Special Provisions	FAQS for School Staff

Programs > National School Lunch Program > Eligibility and Verification > Household Applications

Household Applications

The forms and letters on this page are for schools operating NSLP in School Year 2021-2022. For schools that are operating the Seamless Summer Option (SSO) in SY 2021-2022, please click here for information, forms, and resources specific to processing school meal applications as an SSO operator during the school year.

2021-2022 School Meal Applications

Please Note
CEs may find additional information about household applications and determining eligibility in the Administrator’s Reference Manual (ARM), Section 4, Eligibility Determination.

Click the links below to download the appropriate 2021-2022 school meal applications and letters:

English

Spanish Version

2021-2022 Standard (Multi-Child) Application for Free and Reduced-Price School Meals

2021-2022 Multi-Use Application for Free and Reduced-Price School Meals

2021-2022 Multi-Child Application for Free and Reduced-Price School Meals (Nonpublic School Version)*

2021-2022 Application Directions

2021-2022 Application Letter to Household for Free and Reduced-Price School Meals

* The nonpublic school version includes a question to collect ethnicity and racial data. This version is intended for CEs that do not have access to the Public Education Information Management Systems (PEIMS) or another method of collecting and retaining ethnicity or racial data.

2021-2022 Income Eligibility Guidelines for Determining Free and Reduced Price Benefits

School Meal Application Letters

Please Note
TDA has revised the sample letters. The description provided for each letter explains the appropriate use of each letter.

Click the links below to download the appropriate letters:

English

Eligibility Based on Predetermined Eligibility for a Categorical Program-Supplemental Nutrition Assistance Program (SNAP); Temporary Assistance for Needy Families (TANF); Food Distribution Program on Indian Reservations (FDPIR); Foster; Migrant; Homeless, Runaway, or Displaced; Even Start, Head Start, or Early Head Start

Letter to Household, Directly Certified Free Eligibility for Household - Sample notification letter when all students in household are directly certified to be eligible for free meals. Spanish Version
Letter to Household, Directly Certified Reduced-Price Eligibility for Household - Sample notification letter when all students in household are directly certified to be eligible for reduced-price meals. Spanish Version
Letter to Household, Directly Certified Free Eligibility for Individual Student(s) - Sample notification letter when one or some of the students in household are directly certified to be eligible for free meals. Spanish Version

Eligibility Based on an Household Meal Application

Letter to Household, Eligibility Based on Household Meal Application - Sample notification letter when the CE has determined student/child eligibility based on information reported on an application. Spanish Version

Media Release Prototype

Regulations require that prior to or during the first week of school, a public release be made to the local news media, the unemployment office and any major employers who are contemplating layoffs within the school’s attendance area. When sent to the news media, the letter to parents, application form, and a complete income scale (free and reduced-price guidelines) or the same information put in a narrative form will constitute a public release. TDA has provided this prototype media release (Spanish version) or media release Provision 2 (Spanish version) and media release CEP (Spanish version) for CEs to customize and use each school year.

Assistance available in English and Spanish. Please call 877-TEX-MEAL (877-839-6325) for help.

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, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

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 Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may 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 complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: How to File a 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:

Mail:

U.S. Department of Agriculture

Office of the Assistant Secretary for Civil Rights

1400 Independence Avenue, SW

Washington, D.C. 20250-9410

Fax: (202) 690-7442; or

Email: program.intake@usda.gov.

This institution is an equal opportunity provider.

Texas Department of Agriculture

Commissioner Sid Miller