Our school may be eligible for Federal and State funds
and you can help us by answering a few brief questions. It is ESSENTIAL
that we receive this information from each family. It is for statistical purposes only and NO NAMES WILL EVER BE USED.
INCOME ELIGIBILITY GUIDELINES
For Free and Reduced Price Meals or Free Milk
Effective July 1, 2007 - June 30, 2008 |
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Household Size
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Reduced Price Meal
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Free Meals
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Annual
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Monthly
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Bi-Weekly
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Weekly
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Annual
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Monthly
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Bi-Weekly
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Weekly
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1
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18,889
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1,575
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727
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363
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13,2730
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1,207
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511
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256
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2
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25,327
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2,111
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875
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488
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17,797
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1,484
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685
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343
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3
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31,765
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2,648
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1,222
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611
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21,580
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1,799
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830
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415
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4
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37,000
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3,084
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1,470
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735
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26,845
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2,236
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1,033
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517
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5
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44,641
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3,721
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1,717
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869
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31,369
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2,615
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1,207
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604
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6
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51,079
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4,257
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1,965
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983
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35,893
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2,992
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1,381
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691
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7
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57,517
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4,794
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2,213
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1,107
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40,417
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3,369
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1,555
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775
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8
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63,955
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5,330
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2,460
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1,230
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44,941
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3,746
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1,729
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865
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Each Additional Family Member
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6,438
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537
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248
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124
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4,524
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377
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174
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87
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Please check YES or NO in each category:
A: Based on your family size is your annual income less than the amount listed? YES NO
Is your family eligible for food stamps even though you may not be receiving them? YES NO
B: Are you receiving assistance under the Aid To Families With Dependent Children Program? (Public Assistance)
YES
NO
C: Are any of your children eligible to receive medical assistance under the Medicaid Program? YES NO
List names and grade level of your children in our school:
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