The New Lisbon School District today announced its policy for children unable to pay the full price of meals served under the National School Lunch Program and School Breakfast Program or milk for split-session students served under the Special Milk Program. Each school office and the central office has a copy of the policy, which may be reviewed by any interested party.

The following household size and income criteria will be used for determining eligibility. Children from families whose annual income is at or below the levels shown are eligible for free and reduced price meals or free milk if a split-session student does not have access to the school lunch or breakfast service.

FAMILY SIZE INCOME SCALE
For Determining Eligibility for Free and Reduced Price Meals or Milk

 

ANNUAL INCOME LEVEL

MONTHLY INCOME LEVEL

 

Family
 (Household) Size

 

Free

Must be at or below
figure listed

 

Reduced Price

Must be at or between
figures listed

 

Free

Must be at or below
figure listed

 

Reduced Price

Must be at or between
figures listed

1

 

$18,954

 

$ 18,954.01    and    $26,973

 

$ 1,580

 

   $1,580.01    and  $2,248

2

 

25,636

 

   25,636.01    and      36,482

 

2,137

 

     2,137.01    and    3,041

3

 

32,318

 

   32,318.01    and      45,991

 

2,694

 

     2,694.01    and    3,833

4

 

39,000

 

   39,000.01    and      55,500

 

3,250

 

     3,250.01    and    4,625

5

 

45,682

 

   45,682.01    and      65,009

 

3,807

 

     3,807.01    and    5,418

6

 

52,364

 

   52,364.01    and      74,518

 

4,364

 

     4,364.01    and    6,210

7

 

59,046

 

    59,046.01   and      84,027

 

4,921

 

     4,921.01    and    7,003

8

 

65,728

 

   65,728.01    and      93,536

 

5,478

 

5,478.01    and    7,795

For each additional household member, add

 


+ 6,682

 


+  6,682         and      +9,509

 


+ 557

 


     + 557         and    + 793

 

Application forms are being sent to all homes with a notice to parents or guardians. To apply for free or reduced price meals or free milk, households must fill out the application and return it to the school (unless notified at the start of the school year that children are eligible through direct certification). Additional copies are available at the office in each school. The information provided on the application will be used for the purpose of determining eligibility and may be verified at any time during the school year by agency or other program officials. Applications may be submitted at any time during the year.

To obtain free or reduced price meals or free milk for children in a household where one or more household members receive FoodShare, Food Distribution Program on Indian Reservations (FDPIR), or Wisconsin Works (W-2) cash benefits, list the FoodShare, FDPIR or W-2 case number, program name, list the names of all school children, sign the application, and return it to the school office.

For the school officials to determine eligibility for free or reduced price meals or free milk of households not receiving FoodShare, FDPIR or W-2 cash benefits, the household must provide the following information requested on the application: names of all household members, total number of household members, and the adult signing the application form must also list the last four digits of his or her Social Security Number or mark the box to the right of “Check if no SSN”. Also, the income received by each household member must be provided by amount and source (wages, welfare, child support, etc.).

Under the provisions of the free and reduced price meal and free milk policy Danielle Klinker, JHHS Administrative Assistant, will review applications and determine eligibility. If a parent or guardian is dissatisfied with the ruling of the official, he/she may wish to discuss the decision with the determining official on an informal basis. If the parent/guardian wishes to make a formal appeal, he/she may make a request either orally or in writing to: School District of New Lisbon, Scott Hickey, Superintendent, 500 S. Forest Street, New Lisbon, WI 53950, (608)562-3700 ext. 1522.

If a hearing is needed to appeal the decision, the policy contains an outline of the hearing procedure.

If a household member becomes unemployed or if the household size changes, the family should contact the school. Such changes may make the household eligible for reduced price meals or free meals or free milk if the household income falls at or below the levels shown above, and they may reapply at that time.

Children formally placed in foster care are also eligible for free meal benefits. Foster children may be certified as eligible without a household application. Households with foster children and non-foster children may choose to include the foster child as a household member, as well as any personal income available to the foster child, on the same application that includes their non-foster children.

The information provided by the household on the application is confidential. Public Law 103-448 limits the release of student free and reduced price school meal eligibility status to persons directly connected with the administration and enforcement of federal or state educational programs. Consent of the parent/guardian is needed for other purposes such as waiver of textbook fees. 

 

Nondiscrimination 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:
    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:
    Intake@usda.gov