Free/Reduced Meals

Printable Skyward Application Instructions

Prrintable Skyward Application Instructions Spanish

Apply for Free/Reduced Meals Online – Instructions

Parents log in to Skyward Family Access with your parent login and password. Select “Food Service” from the left menu.

Select any one student from the drop‑down list. Click “Applications.” A pop‑up will appear showing any pending applications. Return to this page to check status.

Only one (1) application needs to be filled out per household.

First Step: You MUST select a student to begin the application process. You can later add any remaining household members as instructed below. To start an application, click on “Add Application.”

If you are unable to add an application and receive a Direct Cert message, this means the State directly certified the application already and the status is FREE. Med‑Red = (Medicaid) Reduced status.

Application for Free and Reduced Price School Meals

Letter to Parents

Children need healthy meals to learn. Jordan School District offers healthy meals every school day. Children may qualify for free meals or for reduced‑price meals. Reduced price is $.30 for breakfast and $.40 for lunch. The application includes instructions and a Federal Income Chart.

1. WHO CAN GET FREE OR REDUCED PRICE MEALS?

• Children in households receiving SNAP, FDPIR, or TANF are eligible for free meals.

• Foster children under the legal responsibility of a foster care agency or court are eligible for free meals.

• Children participating in Head Start are eligible for free meals.

• Children who meet the definition of homeless, runaway, or migrant are eligible for free meals.

• Children may receive free or reduced‑price meals if household income is within Federal Income Eligibility Guidelines.

2. HOW DO I KNOW IF MY CHILDREN QUALIFY AS HOMELESS, MIGRANT, OR RUNAWAY?

If your household lacks a permanent address, is staying in temporary housing, relocates seasonally, or includes children who left their prior household, contact 801‑567‑8765 or julie.dunn@jordandistrict.org.

3. DO I NEED TO FILL OUT AN APPLICATION FOR EACH CHILD?

No. Use one application for all students in your household. Return completed applications to: Nutrition Services, 7905 S Redwood Rd, West Jordan, UT 84088 or email to julie.dunn@jordandistrict.org.

4. SHOULD I FILL OUT AN APPLICATION IF I RECEIVED A LETTER SAYING MY CHILDREN ARE ALREADY APPROVED?

No. Follow the instructions in the letter. If any children were missing, contact Julie at 801‑567‑8765.

Federal Income Chart (School Year 2016–17)

Household Size – Yearly / Monthly / Weekly 1 – 21,978 / 1,832 / 423 2 – 29,637 / 2,470 / 570 3 – 37,296 / 3,108 / 718 4 – 44,955 / 3,747 / 865 5 – 52,614 / 4,385 / 1,012 6 – 60,273 / 5,023 / 1,160 7 – 67,951 / 5,663 / 1,307 8 – 75,647 / 6,304 / 1,455 Each Additional Person: +7,696 yearly / +642 monthly / +148 weekly

Instructions for Applying

Select “I have read the Instructions for Applying and would like to continue the application.”

Follow the steps in order. If unsure, contact Julie at 801‑567‑8765 or julie.dunn@jordandistrict.org.

Use a pen when filling out the paper version.

Step 1: Child Names

List ALL household members who are infants, children, and students up to and including grade 12. They do NOT have to be related to you.

Include:

• Children age 18 or under supported by household income

• Foster children

• Children who are homeless, migrant, or runaway

Definition of Household Member: Anyone living with you who shares income and expenses.

Step 2: Benefits

Do any household members currently participate in SNAP, TANF, or FDPIR?

If YES: Check the box, write the case number, and skip Step 3.

If NO: Complete Step 3.

Step 3: Gross Income

Report income for ALL household members.

A. Child Income

Include total income earned by all children.

B. All Adult Household Members

List all adults not listed in Step 1, including yourself. For each person, report income from:

• Earnings from work

• Public assistance, child support, alimony

• Pensions, retirement, all other income

If no income, write “0.”

Total Household Members: 8 Last Four Digits of SSN of Primary Wage Earner: 1234 Check box if no SSN.

Step 4: Signature

You must certify that all information is true and all income is reported. School officials may verify the information. Providing false information may result in loss of benefits and prosecution.

Required information:

• Street Address: 1234 Thisismy Street

• City: Anytown

• State: UT

• Zip Code: 84084

• Daytime Phone: (801) 123‑4567

• Printed Name of Adult Completing Form: Mom Carter

• Signature: <Signed Electronically>

• Date: 05/09/2017

• Email (optional): mom@email.com

Optional: Ethnicity and Race

This information is optional and does not affect eligibility.

Ethnicity (select one):

• Hispanic/Latino

• Not Hispanic/Latino

Race (select one or more):

• Asian

• American Indian or Alaska Native

• Black or African American

• White

• Native Hawaiian or Other Pacific Islander

Review and Submit

Review the completed application. Click “Submit Application.” The application is NOT submitted until the button is clicked.

If you still see the NOTE message, the application has not been submitted.

Application Helper

The Food Service application was successfully submitted.

Pending Application: Application Date: Tue May 9, 2017 Status: Waiting for Approval

Editing a pending application will mark it as “Not Submitted” and it must be resubmitted.

Household Members (Submitted Application)

Student Carter – Student: Yes – Foster: No Brother Carter – Student: Yes – Foster: No Sister Carter – Student: Yes – Foster: No Baby Carter – Student: No – Foster: No

Income Information (Submitted Application)

Dad Carter – Earnings: 12,000.00 – Public Assistance: 0.00 – Other Income: 0.00 Mom Carter – Earnings: 5,200.00 – Public Assistance: 0.00 – Other Income: 0.00 Big Brother – Earnings: 6,000.00 – Public Assistance: 0.00 – Other Income: 0.00 Big Sister – Earnings: 0.00 – Public Assistance: 0.00 – Other Income: 0.00 Child Income – 0.00 in all categories

Total Annual Income: 23,200.00

Printable Application

Printable Application Spanish

2025–2026 Household Application for Free and Reduced Price School Meals

ADA‑Compliant Plain‑Text Version

APPLY ONLINE: RETURN TO (School/District Name): ADDRESS:

Complete one application per household. Please use a pen (not a pencil).

STEP 1 — List ALL Children in the Household

List ALL children, infants, and students up to and including grade 12. Attach another sheet of paper if you need space for more names.

Do not forget to list: • Infants • Children attending other schools • Children not in school • Children not applying for benefits • Children not related to you who live in your household

For each child, provide: • Child’s First Name • Middle Initial • Child’s Last Name • Grade

(Blank rows for multiple children)

Check all that apply for each child:

☐ Foster Child ☐ Head Start ☐ Migrant ☐ Runaway ☐ Homeless

If you checked any of these boxes, refer to the Application Instructions, Step 1: Part C & Part D.

STEP 2 — Participation in Assistance Programs

Do any household members (including you) participate in: SNAP, TANF, or FDPIR?

☐ NO → Go to STEP 3 ☐ YES → Write case number here and proceed to STEP 4.

CASE NUMBER (NOT EBT NUMBER): (Write only one case number.)

STEP 3 — Household Members and Income

List ALL household members and income for each member before taxes and deductions.

A. Adult Household Members

List all adult household members not listed in Step 1 (including yourself), even if they do not receive income.

For each adult, report total gross income (whole dollars only) for each source. If no income, write “0.” Leaving fields blank certifies there is no income to report.

Income Categories to Report (for each adult):

1. Earnings from Work Amount: $_____ How often received: ☐ Weekly ☐ Every 2 Weeks ☐ Twice a Month ☐ Monthly ☐ Annual

2. Public Assistance, Child Support, Alimony Amount: $_____ How often received: ☐ Weekly ☐ Every 2 Weeks ☐ Twice a Month ☐ Monthly

3. Pensions, Retirement, Social Security, SSI, VA Benefits, All Other Income Amount: $_____ How often received: ☐ Weekly ☐ Every 2 Weeks ☐ Twice a Month ☐ Monthly

Total Household Members (Children and Adults):

Last Four Digits of Social Security Number of Primary Wage Earner or Other Adult Household Member:

☐ Check if no Social Security Number

(See application back for list of income sources.)

STEP 3B — Child Income

Sometimes children in the household earn or receive income.

Enter the total income received by ALL children listed in Step 1 (before taxes and deductions):

Child Income: $_____

How often received: ☐ Weekly ☐ Every 2 Weeks ☐ Twice a Month ☐ Monthly ☐ Annual

STEP 4 — Contact Information and Adult Signature

RETURN COMPLETED FORM TO YOUR CHILD’S SCHOOL.

Insert school address here.

Certification statement: “I certify (promise) that all information on this application is true and that all income is reported. I understand that this information is given in connection with the receipt of Federal funds, and that school officials may verify (confirm) the information. I am aware that if I purposely give false information, my children may lose meal benefits, and I may be prosecuted under applicable State and Federal laws.”

Print Name of Adult Signing the Form: ____________________ Signature of Adult: ____________________ Today’s Date: ____________________

Mailing Address (if available): ____________________ City: ____________________ State: ____________________ Zip: ____________________

Phone (optional): ____________________ Email (optional): ____________________

Sources and Examples of Income

Earnings from Work

• Salary, wages, cash bonuses, tips, commissions • Net income from self‑employment (farm or business) • For U.S. Military: basic pay and cash bonuses (do NOT include combat pay, FSSA, or privatized housing allowances) • Allowances for off‑base housing, food, and clothing

Public Assistance, Alimony, Child Support

• Unemployment benefits • Workers’ compensation • Supplemental Security Income (SSI) • Cash assistance from State or local government • Alimony payments • Child support payments • Veterans benefits • Strike benefits

Pensions, Retirement, All Other Income

• Social Security/Disability (including railroad retirement and black lung benefits) • Private pensions or disability benefits • Income from trusts or estates • Annuities • Investment income • Earned interest • Rental income • Regular cash payments from outside the household

Examples of Income for Children

• A child has a regular full‑ or part‑time job • A child who is blind or disabled receives Social Security benefits • A child receives Social Security benefits due to a parent’s disability, retirement, or death • A friend or extended family member regularly gives a child spending money • A child receives regular income from a private pension fund, annuity, or trust

Summer EBT Information Sharing Opt‑Out

☐ No, I DO NOT want information from my Free and Reduced‑Price School Meals Application shared with the Department of Workforce Services and Utah State Board of Education to issue Summer EBT benefits. I understand that if my information is not shared, I will need to apply with the Department of Workforce Services to determine Summer EBT eligibility.

OPTIONAL — Children’s Ethnic and Racial Identities

This information is confidential and optional. It does not affect eligibility.

Ethnicity (check one):

☐ Hispanic or Latino ☐ Not Hispanic or Latino

Race (check one or more):

☐ American Indian or Alaska Native ☐ Asian ☐ Black or African American ☐ Native Hawaiian or Other Pacific Islander ☐ White

Return this completed form to your child’s school. Do not mail, fax, or email completed applications to the U.S. Department of Agriculture.

For School Use Only — Do Not Fill Out

Annual Income Conversion: • Weekly × 52 • Every 2 Weeks × 26 • Twice a Month × 24 • Monthly × 12

Do not annualize income unless more than one income frequency is listed.

Eligibility: ☐ Free ☐ Reduced ☐ Denied

☐ Error Prone

Determining Official’s Signature: __________ Date: ________ Confirming Official’s Signature: __________ Date: ________ Verifying Official’s Signature: __________ Date: ________

Use of Information Statement

(Excerpt from document:) “The Richard B. Russell National School Lunch Act requires that we use information from this application to see who qualifies for free or reduced price meals. We can only approve complete forms.”

Information may be shared with education, health, and nutrition programs to deliver benefits. Inspectors and law enforcement may use information to ensure program rules are met.

Applications for foster children or households receiving SNAP, TANF, or FDPIR do not need to list a Social Security number.

Some children qualify for free meals without an application (foster, homeless, migrant, runaway). Contact your school for assistance.

Civil Rights Statement

This institution is prohibited from discriminating based on 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 available in languages other than English. Persons with disabilities needing alternative communication formats should contact the administering agency or USDA’s TARGET Center at (202) 720‑2600 or the Federal Relay Service at (800) 877‑8339.

To file a program discrimination complaint, complete Form AD‑3027 (available online or at USDA offices) or write a letter including: • Name • Address • Telephone number • Description of alleged discriminatory action

Submit by mail, fax, or email:

MAIL: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250‑9410

FAX: (833) 256‑1665 or (202) 690‑7442 EMAIL: program.intake@usda.gov

Do not mail applications to this address — only discrimination complaints.

This institution is an equal opportunity provider.

Printable Application Instructions

Printable Application Instructions Spanish

How To Apply for Free and Reduced Price School Meals

“Please use these instructions to help you fill out the application for free and reduced price school meals.”

You only need to submit one application per household, even if your children attend more than one school in the district.

The application must be filled out completely to determine eligibility. Follow the steps in order. If you need help, contact your school or district. Use a pen and print clearly.

Step 1: List ALL children, infants, and students up to grade 12

“Tell us how many infants/toddlers, children not in school, and elementary/middle/high school students live in your household.”

Include all household members who are:

• Children age 18 or under supported by the household’s income

• Children in foster care under a formal arrangement

• Children who qualify as homeless, migrant, or runaway

• Students attending the school system, regardless of age

Information to provide for each child

A) Child’s full name B) Whether the child is a student and their grade C) Whether the child is a foster child D) Whether the child is homeless, migrant, or runaway

Foster children count as household members. Adopted children are not considered foster children.

Step 2: Participation in SNAP, TANF, or FDPIR

“If anyone in your household… currently participates in one or more of the assistance programs listed below, your children are eligible for free school meals.”

Programs include:

• SNAP

• TANF

• FDPIR

If no one participates, check “No” and go to Step 3. If anyone participates, write the case number and go to Step 4.

Step 3: List ALL household members and income

“Report all amounts in GROSS INCOME ONLY… Do not include cents.”

General rules

• Use gross income (before taxes/deductions).

• Write “0” where there is no income.

• Mark how often each income type is received.

• Officials may investigate if income appears incorrect.

3A. Income earned by adults

Include all adults living in the household who share income/expenses, even if unrelated or unemployed.

Do not include:

• People who live with you but are not supported by or contributing to household income

• Children already listed in Step 1

Information to provide

1. Names of all adult household members

2. Earnings from work

   • List each job separately

   • Self‑employed individuals report net income

3. Public assistance, child support, or alimony

4. Pensions, retirement, or other income

5. Total household size

6. Last four digits of the signing adult’s Social Security Number

   • If none, leave blank and check the box indicating no SSN

3B. Income earned by children

“List the combined gross income for ALL children listed in Step 1.”

Child income is money paid directly to children from outside the household. Most households do not have child income.

Step 4: Contact information and adult signature

“All applications must be signed by an adult member of the household.”

Provide:

• Mailing address (if available)

• Optional phone number and/or email

• Printed name, signature, and date

Mail the completed application to your school or district.

Optional: Race and Ethnicity

This information is optional and does not affect eligibility. It is used only to ensure compliance with federal civil rights laws.

Important Note

“Please return the application directly to your child's SCHOOL. DO NOT mail, fax, or email completed applications… to the USDA Office of the Assistant Secretary for Civil Rights.”

Printable View Application Status

Printable View Application Status Spanish

1) Click Food Service

2) Click Applications to view Application Status

Family Access Menu Items:

• My Account

• Contact Us

• Exit

SKYWARD® Sections:

• Food Service

• Home

• Applications

Weekly Purchases For: Mon Aug 22, 2022

Current Account Balance: $4.85

Today's Lunch Menu: No lunch menu details are available for the current date.

Lunch Calendar Navigation:

• Previous Week

• Next Week

(Stansbury High School)

2022–2023 Welcome Back Packet

(Stansbury High School) Options: View Totals | Make a Payment

Set Purchase Limit

There are no payment records for this student. Week Total: $0.00

3) Pop‑up shows student account status

If the Lunch Code is Direct Cert, the status is FREE. If the Lunch Code is Med‑Red, the status is Reduced.

Key Pad Number: 32325

Item / Price Section (No itemized purchases listed)

Daily Purchase History

Sun Aug 21, 2022 No purchases for this date.

Mon Aug 22, 2022 Food Service Applications

Food Service Applications Section

• Pending Application

• Add Application

• Print Application

No pending application was found.

Application Records

Temp Application

• Application Date: Thu Jun 30, 2022

• Effective Date: Thu Jun 30, 2022

• Dependents: 0

Academic History

• Application Date: Wed Jan 3, 1900

• Effective Date: Wed Jan 3, 1900

• Dependents: 0

Portfolio

• Application Date: Tue Jan 2, 1900

• Effective Date: Tue Jan 2, 1900

• Dependents: 0

Skylert

• Application Date: Thu Apr 7, 2022

• Effective Date: Mon Jan 1, 1900

Health Info (No additional details provided)

Lunch Code Table (Accessible Text Version)

Lunch Code Records (Newest on Top):

1. Lunch Code: Reduced | Denied: No | Active: Yes | Application Number: (blank)

2. Lunch Code: Reduced | Denied: No | Active: Yes | Application Number: (blank)

3. Lunch Code: Reduced | Denied: No | Active: Yes | Application Number: (blank)

4. Lunch Code: Reduced | Denied: No | Active: Yes | Application Number: (blank)

Important Notes

• The newest application should have a date after July 1, 2022.

• Dates prior to July 1, 2022 indicate that a new application for the current school year must be submitted.

• Fields showing the date “1900” relate to the student being added to the Skyward system. These can be disregarded.