This form helps ensure your child's school gets the funding it deserves. Your child will continue to receive free meals at school.

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* 1. Student First Name

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* 2. Student Last Name

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* 3. Student Long (6-Digit) ID

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* 4. Student Date of Birth (MM/DD/20YY)

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* 5. 2021-2022 Grade

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* 6. 2021-2022 School/Program

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* 7. Number of People Living in Home

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* 8. Total Household Monthly Income is:

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