Free and Reduced Lunch application form

Have you already filled out the online Free and Reduced lunch application for the 2025-26 school year?

YesNo
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Click HERE to enroll another student!

Step 2:
Do any household members (including you) participate in SNAP, TANF, or FDPRI?

YesNo
If Yes, What is your case number? (NOT EBT NUMBER)

Step 4

Contact Information and Adult Signature
“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.”
Name of Adult signing the form:*
Signature of Adult signing the form*

Clear
Date:*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Disclosure: Can school officials share information from my free and reduced-price meal application with Medicaid or the State Children’s Health Insurance Program (AR Kids 1st).

YesNo
Optional:

Children’s ethnic and racial identities. This information is kept confidential and may be protected by the Privacy Act of 1974.
We are required to ask for information about your children’s race and ethnicity. This information is important and helps to make sure we are fully serving our community. Responding to this section is
optional and does not affect your children’s eligibility for free or reduced price meals.
Ethnicity (Check one)

Hispanic or Latino (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish Culture or origin, regardless of race)Not Hispanic or Latino
Race (Check one)

American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite
Should be Empty: