July 1, 2023
St. John’s Lutheran School announced its revised free and reduced price policy for school children unable to pay the full
price of meals served in schools under the National School Lunch Program and the School Breakfast Program.
Local education officials have adopted the following family-size income criteria for determining eligibility:

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Children from families whose current income is at or below those shown are eligible for free or reduced price meals.
Applications are available at the school office. To apply, fill out a Free and Reduced Price School Meals Family
Application and return it to the school. The information provided on the application is confidential and will be used only
for the purpose of determining eligibility. Applications may be submitted any time during the school year. A complete
application is required as a condition of eligibility. A complete application includes: (1) household income from all
sources or Food Stamp/TANF case number, (2) names of all household members, and (3) the signature and last four
digits of social security number or indication of no social security number of adult household member signing the
application. School officials may verify current income or other information provided on the application at any time
during the school year.

Foster children may be eligible regardless of the income of the household with whom they reside. Households with
children who are eligible under the foster, Head Start, homeless, migrant, or runaway programs should contact the
school for assistance in receiving meal benefits. Special Supplemental Nutrition Program for Women, Infants, and
Children (WIC) participants may be eligible for free or reduced price meals.

Children who are members of households currently certified as receiving Food Stamps, TANF or FDPIR are eligible for
free meals. To complete an application, the household must provide the names of the children, a statement that the
household receives the qualifying benefits, the Food Stamps/TANF/FDPIR case number, and the signature of the adult
household member making application. When known by the school that members of a household are receiving
assistance from Food Stamps, TANF or FDPIR, households will be notified of their children’s eligibility for free school
meals. If any children in the household were not listed on the eligibility notice or not listed on the application, the
household should contact the school to have benefits extended to all children in the household.

If a family member becomes unemployed or if family size changes, the family should contact the school to file a new
application. Such changes may make the children of the family eligible for these benefits.

Under the provisions of the policy, the Administrative Assistant will review the applications and determine eligibility. If
a parent is dissatisfied with the ruling of the determining official, they may wish to discuss the decision with the hearing
official on an informal basis or he/she may make a request either orally or in writing to the Administrator/Principal.

Hearing procedures are outlined in the policy. A complete copy of the policy is on file in each school and in the central
office where any interested party may review it.

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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

This institution is an equal opportunity provider.

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