Instructions for Applying for Free and Reduced-Price School Meals, 2023-2024

Please use these instructions to complete the free or reduced-price school meals application. Submit one application per household, even if the children in the household attend more than one school in Liberty Hill ISD. Please use a pen (not a pencil) when completing the application. The application must be filled out completely in order for the school to make a determination if the children in your household qualify for free or reduced-price school meals. An incomplete application cannot be approved. Please contact Lark Nabi at 512-260-5574 or childnutrition@libertyhill.txed.net with your questions.

Step 1:         List All Household Members Who Are Infants, Children, And Students Up to and Including Grade 12.

• List each child’s name. 

• Print first name, middle initial, and last name for each child in the household in the spaces. If there are more children than lines, use the back of the application to record additional names.
• Include all household members who are age 18 or under and are supported with the household’s income including children who are not enrolled in the district. Children do NOT have to be related to anyone in the household to be a part of the household.

• Mark the box following the child’s name to show if the child is a student in the Liberty Hill ISD.
• Record the child’s grade if the child is in school.
• Check the appropriate box if a child qualifies for free meals as participant in the foster care system, Head Start (including Early Head Start) or if a child meets the criteria for homeless, migrant, or runaway.

Checking Foster indicates that a foster care agency or court has placed the child in your home. If the application is being submitted for foster children only, complete Step 1, skip Steps 2-3, and complete Step 4.

Step 2:         Participating in a Categorical Eligibility Program

• Do any household members (including you) currently participate in SNAP, TANF, and/or FDPIR?

• If a child or adult in the household participates in Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance to Needy Families (TANF), record the Eligibility Determination Group (EDG) number in the space.
• If a child or adult in the household is a participant in Food Distribution Program for Households on Indian Reservations (FDPIR), circle YES to indicate participation. The Liberty Hill ISD will contact you to obtain documentation of FDPIR participation.

• If the students in the household are eligible based on SNAP, TANF, or FDPIR, skip Steps 3, and complete Step 4.
• If any children in the household are participants in one of the following programs—Foster, Head Start, Homeless, Migrant, or Runaway, skip Steps 3 and complete Step 4.

Step 3:         Report Income for All Household Members

 Part A. Last Four Digits of Social Security Number (SSN) of an Adult Household Member

• Provide the last four digits of the Social Security number (SSN) of an adult in the household or check the box for no SSN. A social security number is not required to apply for these programs.

Part B. Income for All Adult Household Members (including yourself)

• Record the first and last name of each adult in the household in the space provided.

• If there are more adults in the household than available spaces, use the back of the application. 
• Include all adults living in the household that share income and expenses, even if the adult is not related to anyone in the household and does not receive any income. Do not include adults that are not supported by the household’s income and do not contribute income to the household.

• Record the amount of income the adult receives under the type of income: Working Earnings; Public Assistance/Child Support/Alimony; Pensions/ Retirement/Social Security/Supplemental Security Income (SSI); and All Other.

• Report all amounts in gross income only and in whole dollars. Gross income is the total income received before taxes or deductions. Ensure that the income reported has not been reduced by the amounts deducted for taxes, insurance premiums, or any other purpose. The Adult Income Information Box (next page) provides additional information on the types of income that need to be reported. Foster children may be included as a member of the household or may be included on a separate application.
• Write a 0 in any field where there is no income to report. If you write 0 or leave any fields blank, you are certifying (promising) that there is no income to report. If local officials have known or available information that the household income was reported incorrectly, the application will be verified for cause.

• Select how often each type of income is received (frequency).
  W = Weekly, E = Every 2 Weeks, T = Twice per Month, M = Monthly, A = Annually

Part C. Income for Children in the Household

• Record total income for all children in the household who receive regular income by how often income is received (frequency). The Child Income Information Box (below) provides additional information on the types of income that needs to be reported for children in the household.
• Do not annualize income to determine eligibility unless more than one income frequency is listed. 
  Annual Income Conversion: weekly x 52, every two weeks x 26, twice a month x 24, monthly x 12.
  

Part D. Total Household Members

• Record the total number of children and adults in the household in the appropriate box. This number MUST be equal to the number of household members listed in Step 1 and Step 3. It is very important to list all household members as the size of the household determines the household eligibility.

Step 4: Provide Contact Information and Adult Signature

• Read the certification statement.
• Write your current address and contact information in the space provided. Sharing a phone number, email address, or both is optional, but helps us reach you quickly if we need to contact you. If you have no permanent address, this does not make your children ineligible for free or reduced-price school meals.
• Print the name of the adult signing the form, sign the form, and record today’s date in the appropriate spaces.
• All applications must be signed by an adult household member. By signing the application, the household member is promising that all information has been truthfully and completely reported. Before completing this section, please read the privacy and civil rights statements on the back of the application. 

MUTLI-USE APPLICATION – Step 5 (Optional): Sharing Information with Other Programs

• Completing this section will not change whether your children are eligible for free and reduced-price meals. 
• To provide your permission to share household information provided on the application with other programs, you MUST select/circle the program(s) or benefit(s) from the list.

NONPUBLIC SCHOOL APPLICATION – Step 5 (Optional): Race and Ethnicity

• Completing this section is optional and does not affect your children’s eligibility for free or reduced-price meals.
• Select the child’s ethnicity (select only one option)
• Select the child’s race (select all that apply)

Return the Application

• Return the application to 301 Forrest St. Liberty Hill, TX 78642, and/or your child’s school.

The income eligibility guidelines (right) are based on 130% (free) and 185% (reduced) of the federal poverty guidelines and are
effective July 1, 2023 – June 30, 2024.