GVA North Permission to Share Free & Reduced Lunch Information Logo

  • Permission to Share Free & Reduced Lunch Information

  • 2023-24 Free and Reduced Fees Application

    Please complete a Free and Reduced Lunch application before continuing through the form. After filling out the application, come back to this form and complete it. All students are eligible for free lunch as of the 2023-24 school year. However, to qualify for free or reduced fees (materials, field trips, etc…), parents must still fill out the free/reduced meal application and allow Charter School Institute to share this information with the school.

  • Below are common questions and answers to help you with the application process.

    Who can RECEIVE free OR REDUCED-PRICE meals?

    • All children in households receiving benefits from the Supplemental Nutrition Assistance Program (SNAP), the Food Distribution Program on Indian Reservations (FDPIR), Medicaid or Temporary Assistance for Needy Family (TANF/Colorado Works – Basic Cash Assistance or State Diversion), are eligible.
    • Foster children that are under the legal responsibility of a foster care agency or court are eligible for free fees. Foster children may be added as a household member of the foster family if the foster family chooses to apply. Including foster children as household members may help other children qualify for benefits. If the foster family is not eligible, it does not prevent a foster child from receiving benefits.
    • Children who qualify for their district’s Head Start program are eligible.
    • Children who meet the definition of homeless, runaway, or migrant are eligible.
    • Children may receive free or reduced-price fees if your household’s income is within the limits of the Federal Income Eligibility Guidelines.  See the chart below for more information on maximum income allowed in order to qualify:

     

  • Image-35

  • Once you have completed the lunch application, please return back to the form to give permission to share your information with GVA North.

     

    • Click Here to Fill Out a 2023-24 Lunch Application

     

    Thank you!

  • Dear Parent/Guardian:

    If you received notification that your student(s) qualified for free or reduced-price school meals, this information may be shared with GVA North waive specific  program fees you might otherwise be required to pay.

    GVA North cannot share your information with anyone else. You are not required to consent to release your information; this will not affect your student(s) eligibility for school meals.

    Complete this form if you wish to share your information with specific GVA North programs.

  • If you marked any or all of the boxes above, please fill out the next section to ensure your information is shared with your household's child(ren). Your information will be shared only with the programs you checked.

  • Powered by Jotform SignClear

  • For more information, you may call Maggie Necaise at (720) 626-2648 or e-mail at maggienecaise@csi.state.co.us

     Non-discrimination Statement: In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits.  Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339.  Additionally, program information may be made available in languages other than English.

     To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form.

     To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights; 1400 Independence Avenue, SW Washington, D.C. 20250-9410. (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov. This institution is an equal opportunity provider.

  • Should be Empty: