Your school participates in the Community Eligibility Provision, which means all students qualify for free meals. However, to determine eligibility to receive additional benefits beyond free meals for your child(ren) and school, please complete a household income form. Return form to: [firstname.lastname@example.org or Anna Wingate, Student Services 700 Glasgow Street Cambridge, Md 21613]
1. Select the total number of people in your household. Be sure to include all children and adults, related and un-related, that live in a single dwelling and share income and expenses.
2. Select the box that represents the range of annual household income. Make sure to include all of the following income sources: work, welfare, child support, alimony, pensions, retirement, Social Security, SSI, VA benefits, child income and/or all other income. The amount should be before any deductions for taxes, insurance, medical expenses, child support, etc.