Please use
these instructions to help you fill out the application for free or reduced
price school meals. You only need to submit one application per household, even
if your children attend more than one school in the Hull Public Schools.
The application must be filled out completely to certify your children for free
or reduced price school meals. Please follow these instructions in order! Each
step of the instructions is the same as the steps on your application. If at
any time you are not sure what to do next, please contact the main office of
the school where your child attends (HHS 781-925-3000, MMS 781-925-2040 or JES
781-925-4400).
|
STEP 1: LIST ALL HOUSEHOLD MEMBERS WHO ARE INFANTS, CHILDREN, AND STUDENTS
UP TO AND INCLUDING GRADE 12
|
|||
|
Tell us how many infants,
children, and school students live in your household. They do NOT have to be
related to you to be a part of your household.
Who should I
list here? When
filling out this section, please include ALL members in your household who
are:
·
Children age 18 or under AND are supported with the household’s
income;
·
In your care under a foster arrangement, or qualify as homeless,
migrant, or runaway youth;
·
Students attending the Hull Public Schools, regardless of age.
|
|||
|
A) List each
child’s name. Print each child’s name. Use one line of the application
for each child. When printing names, write one letter in each box. Stop if
you run out of space. If there are more children present than lines on the
application, attach a second piece of paper with all required information for
the additional children.
|
B) Is the child a student in the Hull Public Schools? Mark ‘Yes’ or ‘No’ under
the column titled “Student” to tell us which children attend the Hull Public
Schools. If you marked ‘Yes,’ write the grade level of the student in the
‘Grade’ column to the right.
|
C) Do you have any foster children? If any children listed are foster children,
mark the “Foster Child” box next to the child’s name. If you are ONLY applying for foster
children, after finishing STEP 1,
go to STEP 4.
Foster children who live
with you may count as members of your household and should be listed on your
application.
If you are applying for both foster and non-foster children, go to step 3.
|
D) Are any children homeless, migrant, or
runaway? If you believe any child listed in this section meets this
description, mark the “Homeless, Migrant, Runaway” box next to the child’s
name and complete all steps of the application.
|
PLEASE USE A PEN (NOT A PENCIL) WHEN FILLING OUT THE APPLICATION AND DO
YOUR BEST TO PRINT CLEARLY.
|
STEP 2: DO ANY HOUSEHOLD MEMBERS CURRENTLY
PARTICIPATE IN SNAP, TANF, OR FDPIR?
|
|||
|
If anyone in your household (including you)
currently participates in one or more of the assistance programs listed
below, your children are eligible for free school meals:
·
The Supplemental Nutrition Assistance Program (SNAP)
·
Temporary Assistance for Needy Families (TANF)
·
The Food Distribution Program on Indian Reservations (FDPIR).
|
|||
|
A) If no one in your household participates
in any of the above listed programs:
·
Leave STEP 2 blank and go
to STEP 3.
|
B) If anyone in your household participates
in any of the above listed programs:
·
Write a case number for SNAP, TANF, or FDPIR. You only need to provide
one case number. If you participate in one of these programs and do not know
your case number, contact: the MA SNAP Hotline at 1-866-950-3663.
·
Go to STEP 4.
|
||
|
STEP 3: REPORT INCOME FOR ALL HOUSEHOLD MEMBERS
|
|||
|
How do I report my income?
·
Use the charts titled “Sources
of Income for Adults” and “Sources
of Income for Children,” printed
on the back side of the application form to determine if your household has
income to report.
·
Report all amounts in GROSS INCOME ONLY. Report all income in whole
dollars. Do not include cents.
o Gross income is the total
income received before taxes
o Many people think of income
as the amount they “take home” and not the total, “gross” amount. Make sure
that the income you report on this application has NOT been reduced to pay
for taxes, insurance premiums, or any other amounts taken from your pay.
·
Write a “0” in any fields where there is no income to report. Any
income fields left empty or blank will also be counted as a zero. If you
write ‘0’ or leave any fields blank, you are certifying (promising) that
there is no income to report. If local officials suspect that your household
income was reported incorrectly, your application will be investigated.
·
Mark how often each type of income is received using the check boxes
to the right of each field.
|
|||
|
3.A. REPORT INCOME EARNED BY
CHILDREN
|
|||
|
A) Report all income earned or received by
children. Report the combined gross income for ALL children listed in STEP
1 in your household in the box marked “Child Income.” Only count foster
children’s income if you are applying for them together with the rest of your
household.
What is Child
Income? Child income is money
received from outside your household that is paid DIRECTLY to your children.
Many households do not have any child income.
|
|||
|
3.B REPORT INCOME EARNED BY ADULTS
|
|||
|
Who should I list here?
·
When filling out this section, please include ALL adult members in
your household who are living with you and share income and expenses, even
if they are not related and even if they do not receive income of their own.
·
Do NOT include:
o People who live with you
but are not supported by your household’s income AND do not contribute income
to your household.
o Infants, Children and
students already listed in STEP 1.
|
|||
|
B) List adult household
members’ names. Print the name of each household member in the boxes
marked “Names of Adult Household Members (First and Last).” Do not list
any household members you listed in STEP
1. If a child listed in STEP 1
has income, follow the instructions in STEP
3, part A.
|
C) Report earnings from work. Report all income from
work in the “Earnings from Work” field on the application. This is usually
the money received from working at jobs. If you are a self-employed business
or farm owner, you will report your net income.
What if I am self-employed? Report income from that
work as a net amount. This is calculated by subtracting the total operating
expenses of your business from its gross receipts or revenue.
|
D) Report income from public assistance/child support/alimony.
Report all
income that applies in the “Public Assistance/Child Support/Alimony” field on
the application. Do not report the cash value of any public assistance
benefits NOT listed on the chart. If income is received from child
support or alimony, only report court-ordered payments. Informal but regular
payments should be reported as “other” income in the next part.
|
|
|
E) Report
income from pensions/retirement/all other income. Report all income that
applies in the “Pensions/Retirement/ All Other Income” field on the application.
|
F) Report
total household size. Enter the total number of household members in the
field “Total Household Members (Children and Adults).” This number MUST be
equal to the number of household members listed in STEP 1 and STEP 3. If
there are any members of your household that you have not listed on the
application, go back and add them. It is very important to list all household
members, as the size of your household affects your eligibility for free and
reduced price meals.
|
G) Provide the
last four digits of your Social Security Number. An adult household
member must enter the last four digits of their Social Security Number in the
space provided. You are eligible to apply for benefits even if you do not
have a Social Security Number. If no adult household members have a Social
Security Number, leave this space blank and mark the box to the right labeled
“Check if no SSN.”
|
|
|
STEP 4: CONTACT INFORMATION AND ADULT SIGNATURE
|
|||
|
All
applications must be signed by an adult member of the household. By signing
the application, that household member is promising that all information has
been truthfully and completely reported. Before completing this section,
please also make sure you have read the privacy and civil rights statements
on the back of the application.
|
|||
|
A) Provide
your contact information. Write your current address in the fields
provided if this information is available. If you have no permanent address,
this does not make your children ineligible for free or reduced price school
meals. Sharing a phone number, email address, or both is optional, but helps
us reach you quickly if we need to contact you.
|
B) Print and sign your name. Print the name of the
adult signing the application and that person signs in the box “Signature of
adult.”
|
C) Write today’s
date. In the space provided, write today’s date in the box.
|
D) Share children’s racial and ethnic identities
(optional).
On the back of the application, we ask you to share information about your
children’s race and ethnicity. This field is optional and does not affect
your children’s eligibility for free or reduced price school meals.
|
