A  NEW APPLICATION MUST BE SUBMITTED EACH YEAR (It cannot be submitted on last year’s form). There is a 30-day grace period for free or reduce-priced status from the previous school year to complete and return a new application. If we do not have a new application on file after 30 days, your child(ren) will be changed to full pay status.

If you qualify for meal benefits, your student is eligible for free or reduce-priced breakfast or lunch. The free or reduce-priced status applies to meals only. The student is not eligible to use their free or reduced status for the purchase of ala carte items such as milk. Milk only must be purchased.

YOU ARE RESPONSIBLE FOR ALL CHARGES UNTIL YOUR APPLICATION IS PROCESSED. Fill out the application completely (one application per family) including:

• All students’ full names with school they attend

• Names of all members of the household with their incomes and how often received

• Signature of an adult household member

• Social Security Number of signer

If your student receives Basic Food or TANF you must include the case number on the application (no Social Security Number is needed). Applications will not be processed without a case number.

If your student is a foster child, please submit an application with only his/her name in the foster child section. If you have multiple foster children, you need one application per child. No other children may be on their application.

Have your student drop the completed application in your school cafeteria with the Food Service staff  Kittitas School, and we will process it immediately if possible. We have 10 business days to process the application. You are responsible to purchase meals or bring meals from home until your application has been processed.

Please send cash or a check (checks are encouraged) with the student’s full name written in the memo section to school with them. Have the student submit the cash/check with the Food Service cashier at their school. We do not give change to students; the full amount will be deposited in their account. It is the parent or guardian’s responsibility to ensure that their child has money in his/her account or brings a meal from home.

USDA Non Discrimination Statement

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/ad-3027.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

Para todos los demás programas de asistencia de nutrición del FNS, agencias estatales o locales y sus subreceptores, deben publicar la siguiente Declaración de No Discriminación: De acuerdo con la ley federal de derechos civiles y las normas y políticas de derechos civiles del Departamento de Agricultura de los Estados Unidos (USDA), esta entidad está prohibida de discriminar por motivos de raza, color, origen nacional, sexo (incluyendo identidad de género y orientación sexual), discapacidad, edad, o represalia o retorsión por actividades previas de derechos civiles. La información sobre el programa puede estar disponible en otros idiomas que no sean el inglés. Las personas con discapacidades que requieren medios alternos de comunicación para obtener la información del programa (por ejemplo, Braille, letra grande, cinta de audio, lenguaje de señas americano (ASL), etc.) deben comunicarse con la agencia local o estatal responsable de administrar el programa o con el Centro TARGET del USDA al (202) 720-2600 (voz y TTY) o comuníquese con el USDA a través del Servicio Federal de Retransmisión al (800) 877-8339. Para presentar una queja por discriminación en el programa, el reclamante debe llenar un formulario AD-3027, formulario de queja por discriminación en el programa del USDA, el cual puede obtenerse en línea en: https://www.fns.usda.gov/sites/default/files/resource-files/usda-program-discrimination-complaint-form-spanish.pdf, de cualquier oficina de USDA, llamando al (866) 632-9992, o escribiendo una carta dirigida a USDA. La carta debe contener el nombre del demandante, la dirección, el número de teléfono y una descripción escrita de la acción discriminatoria alegada con suficiente detalle para informar al Subsecretario de Derechos Civiles (ASCR) sobre la naturaleza y fecha de una presunta violación de derechos civiles. El formulario AD-3027 completado o la carta debe presentarse a USDA por:

(1)correo:

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 o (202) 690-7442; o

(3)correo electrónico:program.intake@usda.gov

Esta entidad es un proveedor que brinda igualdad de oportunidades.