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

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  • JCSD 2025-26 Free and Reduced Lunch application

    Please read through document below before filling form out.

  • Step 1:

     List ALL children, infants, and students up to and including grade 12.

  • Child 1 Information

  • Check all that apply to child:
  • Do you need to add another child?

  • Child 2 Information

  • Check all that apply to child:
  • Do you need to add another child?

  • Child 3 Information

  • Check all that apply to child:
  • Do you need to add another child?

  • Child 4 Information

  • Check all that apply to child:
  • Do you need to add another child?

  • Child 5 Information

  • Check all that apply to child:

  • Step 2:

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

  • Step 3 A:

    List ALL household members and income for each member (BEFORE TAXES AND DEDUCTIONS

  • A. All Adult Household Members (Anyone who is living with you and shares income and expenses, even if not related, including you.)


    List all Adult Household Members not listed in STEP 1 (including yourself) even if they do not receive income. For each Household Member listed, if they receive income, report total gross income (before taxes and
    deductions) for each source in whole dollars (no cents) only. If they do not receive income from any source, write ‘0’. If you enter ‘0’ or leave any fields blank, you are certifying (promising) that there is no income to report.

  • Primary Adult household member:

  • How often do are payments received?*
  • Does this adult receive any public assistance, child support, or alimony?*
  • How often do are payments received?*
  • Does this adult receive any Pensions, Retirement, Social Security, SSI, VA Benefits, All others?*
  • How often do are payments received?*
  • Do you need to add another adult's income?*

  • 2nd Adult household member:

  • How often do are payments received?*
  • Does this adult receive any public assistance, child support, or alimony?*
  • How often do are payments received?*
  • Does this adult receive any Pensions, Retirement, Social Security, SSI, VA Benefits, All others?*
  • How often do are payments received?*
  • Do you need to add another adult's income?*

  • 3rd Adult household member:

  • How often do are payments received?*
  • Does this adult receive any public assistance, child support, or alimony?*
  • How often do are payments received?*
  • Does this adult receive any Pensions, Retirement, Social Security, SSI, VA Benefits, All others?*
  • How often do are payments received?*
  • Do you need to add another adult's income?*

  • 4th Adult household member:

  • How often do are payments received?*
  • Does this adult receive any public assistance, child support, or alimony?*
  • How often do are payments received?*
  • Does this adult receive any Pensions, Retirement, Social Security, SSI, VA Benefits, All others?*
  • How often do are payments received?*
  • Do you need to add another adult's income?*

  • 5th Adult household member:

  • How often do are payments received?*
  • Does this adult receive any public assistance, child support, or alimony?*
  • How often do are payments received?*
  • Does this adult receive any Pensions, Retirement, Social Security, SSI, VA Benefits, All others?*
  • How often do are payments received?*

  • Step 3B:

  • Do any children in the house receive any income?
  • How often do are payments received?*

  • 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.”

  • Format: (000) 000-0000.
  • 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).

  • 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)
  • Race (Check one)
  •  
  • Should be Empty: