Welcome to the Collinsville School District electronic application for free and reduced-priced meals for the USDA's National School Lunch & School Breakfast Programs.

This interactive application will guide you through the application process. When you are ready to apply, click the ‘Get started’ button below to begin.

If you would like to apply using the paper application, you can print and complete it and then return it to us at 1902 West Maple, Collinsville, OK, 74021.

 

Before you begin…there are a few things you should know.

If you received a letter from the school saying that your children were automatically approved (directly certified) for free meals for the current school year because someone in your household participates in Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), or Food Distribution Program on Indian Reservations (FDPIR) then you do not need to submit an application.

 

You may apply for school meals any time during the school year by submitting this application directly to your district. You may ask for a paper application, if you prefer, at any time during the school year. If you’re earnings, marital status, or family dynamics change during the current school year, you are encouraged to fill out a new school meal application. Applications are reviewed by local school or district officials before granting free or reduced price benefits. If you receive SNAP benefits, all of your children who attend school automatically qualify for free school meals. Participation in other Federal assistance programs, including TANF also provides automatic eligibility. Please contact your school to determine if you need to fill out an application. If you are eligible for unemployment compensation or The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), you may also be eligible for free or reduced price school meals.

 

We need only one application for all the children in your household that attend school in the Collinsville School District.

 

 

Eligibility for free or reduced-price school meal benefits is based on any one of these three things:

• your total household income and size in the month the application is filled out, or the month before, or
• your child’s individual status as foster, homeless, migrant or runaway, or
• participation in an assistance program by any member of your household

Your US citizenship or immigration status  does not affect your eligibility for free and reduced-price benefits.

STEP 1

 

List ALL Household Members who are infants, children, and students up to and including grade 12. 

 

Definition of Household Member: "Anyone who is living with you and shares income and expenses, even if not related."

Children in Foster care and children who meet the definition of Homeless, Migrant or Runaway are eligible for free meals. Read How to Apply for Free and Reduced Price School Meals for more information. 

Don’t forget to include:

• students that are in grade 12 or below and attend school in a school district other than Collinsville School District
• children that attend daycare or pre-school, or are not of school age, including infants
• anyone 18 years of age or younger living in your household that does not currently attend school

Homeless, Migrant or Runaway Information

Runaway and Homeless Youth Act -
Authorizes community-based runaway and homeless youth projects to provide temporary shelter and care to runaway or otherwise homeless youth who are in need of temporary shelter, counseling, and aftercare services.

**If not, but they chose to leave their prior family or household, contact Collinsville School District for help.**

Migrant Education Program -
Provides services to children who have moved across district lines, within the last three years, in order to accompany or join a parent or guardian who seeks or obtains temporary or seasonal work in agriculture or fishing.

McKinney-Vento Homeless Assistant Act -
Provides Federal money for homeless shelter programs and facilitates public school access for homeless children and youth.

**If not, but your household lacks a permanent address or stays together in a shelter, hotel, or other temporary housing arrangement, contact Collinsville School District for help.**

If you indicated at least one student receives assistance under one or more of the following:

• McKinney-Vento Homeless Assistance Act
• Migrant Education Program
• Runaway and Homeless Youth Act

• or they are in a Court-Appointed Foster Care Arrangement

We will need to confirm that with program staff. If we are unable to do that, you will need to submit an application with income information to determine your benefit level.

STEP 2

 

Do any Household Members (including you) currently participate in one or more of the following assistance programs: 

SNAP, TANF, or FDPIR?

 

If No, click 'Next'

 

A household is defined as a group of people, related or unrelated, that usually live together and share income and expenses.

 

This includes grandparents and other extended family members that are living with you. it also includes people that are not currently living with you but are only away on a temporary basis, such as kids that are away at college. It includes people regardless of age or whether they earn or receive income.

 

You only need to provide one case number. If you participate in one of these programs but do not know your case number, contact your caseworker.

STEP 3

Report Income for ALL Household Members

 

Child Income

Sometimes children in the household earn or receive income. Please include the TOTAL income received by all Household Members listed in STEP 1 here.

If none, click 'Next'

Some common sources of income for children are:

• a full-time or part-time job,
• Social Security benefits if the child is disabled, or is the  beneficiary of another person’s Social Security benefits,
• money regularly received from extended family or friends outside the household, or
• money from a  pension ,  annuity , or  trust

Do not include infrequent earnings, such as income from occasional babysitting or mowing lawns.

 

Income reported here should be the child’s current, gross income.

Gross income means all money earned or received before deductions, such as income taxes, social security taxes, and insurance premiums. You should not report net income, which is the amount of money received in a paycheck. Net income is total (or gross) income, minus taxes, and deductions, and is commonly referred to as “take-home pay”.

 

 

List ALL Adult Household Members (including yourself)

List all Household Members not listed in STEP 1 (including yourself) even if they do not receive income. For each Household Member listed, if they do not receive income, report total gross income (before taxes) for each source in whole dollars (no cents) only. If they do not receive income from any source, enter '0' in the space provided. If you enter '0' or leave any fields blank, you are certifying (promising) that there is no income to report.

Remember, for the purposes of applying for school meal benefits, a household is defined as a group of people, related or unrelated, that usually live together and share income and expenses. 

 

Don’t forget about:

• grandparents or other extended family members that are living with you
• people that are not currently living with you, but are only away on a temporary basis, like kids that are away at college,
• members of your family that are in the military, and are deployed

DO NOT include:

• People who live with you but are not supported by your household's income AND do not contribute income to your household
• Infants, Children, and Students already listed in STEP 1

Adult Income

{addadult1}

On questions about income, all amounts should be {addadult1}'s current gross income.

Gross income means all money earned or received before deductions such as income taxes, social security taxes, and insurance premiums. You should not report net income, which is the amount of money received in a paycheck.

• Earnings from Work

• Public Assistance
• Child Support
• Alimony

• Pensions
• Retirement
• All Other Income

STEP 4

 

I certify (promise)...

that all information on this application is true and that all income is reported. 

 

"I understand that this information is given in connection with the receipt of Federal funds, and that school officials may verify (check) the information. I am aware that if I purposely give false information, my children may lose meal benefits, and I may be prosecuted under applicable State and Federal laws." 

 

Please provide the last four digits of the Social Security number for the person that completed this application ({enterThe}). If that person does not have a Social Security number, please check the box below labeled 'No SSN'.

Note: United States citizenship or immigration status is not a condition of eligibility for free and reduced-price benefits. The non-cash benefits received through the school meal programs are not subject to public charge consideration. In other words, you will not be deported, denied entry to the country, or denied permanent status because you apply for or receive school meal benefits.

Please enter your contact information so we may reach you in the event there are any issues with your application. This information is optional, but we strongly encourage you to provide it.

*Deliberate misrepresentation of information may subject applicants to prosecution under applicable State and Federal law. 

OPTIONAL 

 

We are required to ask for information about your children's race and ethnicity. This information is important and helps to make sure we are fully serving our community. Responding to this section is optional and does not affect your children's eligibility for free or reduced-price meals.

Legal Statements

Please read and acknowledge the following legal statements.

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 submit all of the needed information, we cannot approve your child for free or reduced-price meals. You must include the last four digits of 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 child 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 eligible for free or reduced price meals, and for administration 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 for their programs, auditors for program reviews, and law enforcement officials to help them look into violations of program rules.

 

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, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

 

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 responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or 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 Program Discrimination 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 (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov.

This institution is an equal opportunity provider.

Thank you for completing the Collinsville Public Schools online application for Free and Reduced-Price Meals.

This section contains fields used for calculation of yearly income totals.

YEARLY INCOME TOTALS

Weekly x52, Every 2 Weeks x26, Twice a Month x24, Monthly x12