Household Applications

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.

2022-2023 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 Versions - COMING SOON pending new Nondiscrimination Statement

2022-2023 Standard (Multi-Child) Application for Free and Reduced-Price School Meals

2022-2023 Multi-Use Application for Free and Reduced-Price School Meals

2022-2023 Multi-Child Application for Free and Reduced-Price School Meals (Nonpublic School Version)*

2022-2023 Application Directions

2022-2023 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.

2022-2023 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 coming soon!) or media release Provision 2 (Spanish version coming soon!) and media release CEP (Spanish version coming soon!) 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, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity. Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted 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; or 2. Fax: (833) 256-1665 or (202) 690-7442; or 3. Email: program.intake@usda.gov.

This institution is an equal opportunity provider.