Dear Parent or Guardian: August 18, 2017
Children need healthy meals to learn. Henrico County Public Schools offers healthy meals every school day. Student breakfast costs $1.50 and lunch costs $2.80. Your children may qualify for free meals or for reduced price meals. Reduced price breakfast costs $.30 and lunch costs $.40. All meals served must meet standards established by the U.S. Department of Agriculture. However, if a student has been determined by a doctor to be disabled and the disability prevents the student from eating the regular school meal, the school will make substitutions prescribed by the doctor. A Doctor’s note must be presented in order for special accommodations to be met. A note from a parent/household will not suffice. If a substitution is prescribed, there will be no extra charge for the meal. If your student needs substitutions because of a disability and/or life threatening allergy please contact Jamie Holubar, R.D. at (804) 226-5535 for further information.
Children who are members of households receiving Supplemental Nutrition Assistance Program (SNAP) benefits (formerly the Food Stamp Program) or Temporary Assistance for Needy Families (TANF) are eligible for free meals regardless of income. Foster children who are the legal responsibility of a welfare agency or court are eligible for free meals regardless of the income of the household with whom they reside. Children who are members of households participating in WIC may also be eligible for free or reduced-price meals based on the household’s income. If your total household income is at or below the Federal Income Eligibility Guidelines, shown on the chart below, your child(ren) may get free meals or reduced price meals. Your child(ren)’s application from last school year is only good for the first few days of this school year. YOU MUST SEND IN A NEW HOUSEHOLD APPLICATION FOR EACH SCHOOL YEAR.
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Households that are receiving SNAP or TANF for their children before July 1 may not have to fill out an application. School Nutrition Services Office will notify you in writing of your child’s eligibility and your child will be provided meal benefits, unless you tell the office that you do not wish to receive them. If you are not notified by Monday September 11, 2017, you must submit an application. The application must contain the name of all students in the household, the SNAP or TANF case number, and the signature of an adult household member.
If you do not receive SNAP or TANF benefits for your child(ren) complete the application and return it to the school division. An income based application must contain the child’s name, the names of all household members, and the amount of income each person received last month and how often the income is received. An adult household member must sign the application and include their social security number. If the person does not have a number, check the box provided. If the application is submitted with missing information, it is considered incomplete and will not be processed.
FEDERAL INCOME CHART
For School Year 2017-2018
|For each additional family member, add:
If you are applying for a Foster child, who is the legal responsibility of a welfare agency or court, an application may not be required. Contact Betty Hyatt at (804) 226-5530 for more information. If you are applying for a homeless, migrant, or runaway child, an application may not be necessary. Contact Deborah Reed (homeless liaison) at (804) 652-3854.
- FEDERAL INCOME GUIDELINES: Your child(ren) may be eligible for free or reduced price meals if your household income is within the limits on the Federal Income Guideline chart shown above.
- CONFIDENTIALITY: School officials use the information on the application to determine if your child is eligible to receive free or reduced-price meals and to verify eligibility. As authorized by the National School Lunch Act, the school division may inform officials connected with other child nutrition, health, and education programs of the information on your application to determine benefits for those programs or for funding and/or evaluation purposes.
- VERIFICATION: Your eligibility may be checked by school officials at any time during the school year. School officials may ask you to send information to prove that your child(ren) should get free or reduced price meals.
- FAIR HEARING: If you do not agree with the decision made on your family’s eligibility for free or reduced price meals, you may request a fair hearing by writing Dr. Patrick C. Kinlaw, Superintendent of Henrico County Public Schools at 3820 Nine Mile Rd. Henrico, Virginia 23223 or by calling (804) 226-5544.
- REAPPLICATION: You may reapply for free and reduced price meals any time during the school year. If you are not eligible now but have a change, such as a decrease in household income, an increase in household size, become unemployed or get SNAP or VA TANF for your child, fill out an application at that time.
- OTHER BENEFITS: Your child may be eligible for other benefits such as the Virginia children’s health insurance program and Medicaid. Medicaid and FAMIS can only use the information to identify children who may be eligible for free or low-cost health insurance, and to enroll them in either Medicaid or the Virginia children’s health insurance program. If you do not want us to share this information, please check the appropriate box in step 4 of the application.
If you need help filling out the application form, please contact the school your child attends or the School Nutrition Office at (804) 226-5544
Peggy K. Gordon
Director, Henrico County School Nutrition Services
Privacy Act Statement: 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 last four digits of the social security number of the adult household member who signs the application. The last four digits of the social security number are 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
Non Discrimination Agreement: 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: http://www.ascr.usda.gov/complaint_filing_cust.html, 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: email@example.com.This institution is an equal opportunity provider.