Documents and Forms
For the National School Lunch Program

Free and Reduced Price Meal Process

Application Materials for Free and Reduced Price Meals

• SY 2009-2010: To be used by schools for applications distributed to schools up until July 1, 2010.

  1. Applications
     • English Version - This document contains some verification information for schools. For more information about the verification process, please go to Verification below.
     • Spanish Version
     • Translations of Application Materials into 25 Languages - These can be used as there were no changes to the application this year, however, before using any of these translated versions please also make the additional changes to modify application to reflect programs specific to Wisconsin.
     • Changes to Applications - Changes may be made to customize the forms for your school agency. Identify only the programs offered at your schools, such as lunch, breakfast or after-school snacks. Insert your school/agency name, school contact person, and hearing official.
       • If these are the only changes that you make, you do not need to submit the application for approval.
       • If other changes are made to the Letter to Households, the Application, or Application Instructions you must submit a copy of the changes to DPI for approval prior to mailing to households.
     • Filing Applications Electronically - USDA Guidance Memo with Question and Answers regarding use of electronic transactions for Child Nutrition Programs
  2. Extending Categorical Eligibility to Additional Children in a Household Wisconsin DPI Mailing 09/08/09
     • USDA Policy Memo SP 38-2009 08/27/09
  3. Income Eligibility Guidelines (For School Use Only)
  4. Reimbursement Rates for School Nutrition Programs
  5. Parent Notification Letter for Free and Reduced Price Meals or Milk - Fill Only Form
  6. Parent Notification Letter for Free and Reduced Price Meals or Milk - Form that may be changed. However, if any changes are made to this document they must meet the requirements as listed in the Eligibility Manual on pages 23 (notification of eligibility determination) and page 49 (notification to households about eligibility established through direct certification).
  7. Public Release
  8. Sharing Information with Medicaid/Badger Care Alternate Approved Form
  9. Ways to Assist Families during Economic Downturn 2/27/09 USDA Policy Memo
  10. Communication with Households 12/23/05 USDA Policy Memo
  11. Verification Summary Report will be found under On-line Services on FNS Index page when it is time for this to be completed.
  
  

• SY 2008-2009

  1. Income Eligibility Guidelines (For School Use Only)
  2. Reimbursement Rates for School Nutrition Programs
  
  

• Direct Certification - All LEA'a are required to conduct direct certification every school year.

  1. Extending Categorical Eligibility to Additional Children in a Household Wisconsin DPI Mailing 09/08/09
     • USDA Policy Memo SP 38-2009 08/27/09
  2. Direct Certification Required In All Schools For 2008-09
     • September 15, 2008 - Reminder: Direct Certification Required in All Schools for 2008-09
  3. Automated Direct Certification Process 6/1/08 Memo from Karen Lavallee, Department of Children & Families
  4. Direct Certification WisLine Web Conference - 9/26/08
     • Listen to Recorded Session
     • PowerPoint Presentation
     • Sample Marked Computer Access Request Form
     • Written Instructions for Direct Certification Set Up and First Transfer
     • Frequently Asked Questions
  5. Automated Direct Certification Process Training Videos - These six videos and a trouble shooting guide are highly recommended viewing prior to starting your direct certification process.
     
     

     Video Handouts - Please print these prior to watching the videos for note taking.

     • Process Overview
     • Create WAMS ID
     • Request Mainframe ID
       
       If you have any questions on procedures in the above 3 videos please contact Karen Lavallee, (608) 267-8934.
     • Create Your Student File
     • Transfer Student File using HOD
     • Transfer Student File using WS FTP Client
       
       If you have any questions on procedures in the above 3 videos please contact Diana Gleichauf, (608) 261-6984.
  6. Direct Certification Excel Spreadsheet Template
  7. Direct Certification Eligibility Codes
  8. Direct Certification and Direct Verification of Children in Food Stamp Households: Reauthorization 2004 11/18/04 USDA Policy Memo #5-05
  9. Direct Certification Eligibility Notification Letter
  10. Computer Access Request (DWSW-10-E) - Note: If you are hesitant to reveal your Social Security Number give us at least the last four digits or four digits that you will remember. If you use false numbers and can't remember what they are you will not get access.
  11. Direct Certification in the National School Lunch Program: State Implementation Progress - USDA's Food and Nutrition Office of Research and Analysis Report to Congress
  
  

• Duration of Households' Free and Reduced Price Eligibility Determination

  1. Initial Carry-over of Previous Year's Eligibility: Reauthorization 2004 9/9/05 USDA Policy Memorandum #05-28
  2. Duration of Households' Free and Reduced Price Eligibility Determination: Reauthorization 2004 7/9/04 USDA Policy Memorandum #04-21
  
  

• Eligibility Benefits and Guidance for Runaway, Homeless and Migrant Youth

  1. Midwest Regional USDA Office Guidance School Meal Service to Homeless Students at Private Schools - September 24, 2007
  2. Wisconsin DPI Mailing: Free School Meals for Homeless Students - September 25, 2006
  3. Wisconsin DPI Mailing: Update about Free Meals for Homeless and Migrant Students - October 25, 2005
  4. Establishing Eligibility of Runaway, Homeless and Migrant Youth, FY 05 School and Community Nutrition Programs Policy Memorandum #05-01
  5. Guidance on Determining Categorical Eligibility for Free Lunches and Breakfasts of Runaway, Homeless and Migrant Youth: Reauthorization 2004, FY 04 School and Community Nutrition Programs Policy Memorandum #04-33
  6. Categorical Eligibility for Free Lunches and Breakfasts for Migrant Children, FY 04 School and Community Nutrition Programs Policy Memorandum #04-29
  7. Categorical Eligibility for Free Lunches and Breakfasts of Runaway, Homeless and Migrant Youth: Reauthorization 2004, FY 04 School and Community Nutrition Programs Policy Memorandum #04-24
  8. Guidance on Role of Educational Agency Liaison in Documenting Eligibility of Homeless Children for Child Nutrition Program Benefits
  9. Homeless Liaison Directory for Public Schools
  
  

• Eligibility Benefits for Head Start/Even Start Students

  1. USDA Guidance on Automatic Eligibility for Early Head Start Participants - 8/5/08
  2. Wisconsin DPI Mailing, 6/2/08 - Children Enrolled in Head Start with enclosed USDA Guidance
  
  

• Eligibility Benefits for Military

  1. U.S. Armed Forces Family Supplemental Subsistence Allowance: Excluded from Income Consideration 08/25/06 USDA Policy Memorandum #30-2006
  2. U.S. Armed Forces Family Supplemental Subsistence Allowance: Excluded from Income Consideration 9/9/05 USDA Policy Memorandum #05-29
  3. Military Families and Eligibility in the Child Nutrition Programs 1/19/05 USDA Policy Memorandum #05-13
  4. Exclusion of the Housing Allowance for Military Households in Privatized Housing 7/7/04 USDA Policy Memorandum #04-20
  
  

• Eligibility Benefits for Students in Foster Care, Kinship Care and Chips

  1. Determining Eligibility for Meal/Milk Benefits for Students in Foster Care, Kinship Care and Adoption Assistance - Fact Sheet
  
  

• Eligibility Manual for School Meals - Federal Policy for Determining and Verifying Eligibility - January 2008 - This document has been updated by USDA to include changes implemented with the Child Nutrition Reauthorization Act of 2004

  1. Wisconsin DPI Mailing - Eligibility Determination and Verification Updates and Clarifications - July 31, 2008
  
  
  

• Fair Hearing Procedures

• Income Eligibility Guidelines

  1. School Year 2008-2009
  2. School Year 2007-2008
  
  

• Limited Disclosure of Children's Free and Reduced Price Meal Eligibility and Outreach for the Wisconsin BadgerCare Health Care Coverage

  1. Reaffirmation of Policy on Limited Disclosure of Children's Eligibility Information to the National Assessment of Educational Progress (NAEP) - USDA Guidance Memo, September 29, 2008
  2. Limited Disclosure of Children's Free and Reduced Price Meal Eligibility
  3. Disclosure of Children's Eligibility Information for Health Insurance Programs
  4. Prototype Disclosure of Free and Reduced Price Meal Eligibility Information Agreement
  5. Sharing Information with Medicaid/Badger Care Alternate Approved Form - (This form supplied by The CHILD Project)
  6. Prototype Disclosure of Free and Reduced Price Meal Eligibility Information Agreement - Appropriate for School Personnel
  
  

• Provision 2

  1. May 1, 2008 - Mailing to Authorized Representatives of non-pricing Child Nutrition Programs completing a four-year cycle under Provision 2
  2. Special Assistance Alternatives - Provision 2
  3. Provision 2 Guidance - National School Lunch and School Breakfast Programs
  4. Calendar of School Nutrition Requirements for Provision 2 Base Year Schools
  5. Calendar of School Nutrition Requirements for Provision 2 Non-base Year Schools
  6. 30-Day Carryover and Delayed Implementation for Provision 2 - 9/5/08 USDA Policy Memo
  7. Application materials for Free and Reduced Price Meals
     • SY 2009-2010: Only to be used by schools completing Provision 2 BASE YEAR
       • Free/Reduced Meal Application - contains updated Parent/Guardian letter
       • Public Release
       • Parent Notification Letter for Free and Reduced Price Meals
  
  
  

• Treatment of Family Subsistence Supplemental Allowance and National Flood Insurance Program payments in Income Eligibility Determinations for Food and Nutrition Service Programs

  1. 10/29/05 USDA Policy Memo
  
  
  

• Verification

  1. Interim Rule: Verification of Eligibility for Free and Reduced Price Meals in the NSLP and SBP
  2. Wisconsin DPI Mailing - Eligibility Determination and Verification Updates and Clarifications - July 31, 2008
  3. Verification Forms (Updated 2009) -Supplementary materials that may be used by National School Lunch Program sponsors to meet the annual verification requirement to confirm eligibility for free or reduced price meals of a sample of students.
  4. Verification Training Webcasts
  5. Clarification of Direct Verification - 8/31/06 USDA Policy Memo
  6. Verification Summary Report is found under On-line Services on FNS Index page.
  7. Verification Sample Size Memo 7/25/06 USDA Policy Memorandum
  8. School Communications Concerning Verification Activities 3/2/06 USDA Policy Memorandum
  9. State Agency Ameliorative Action Plans for Verification 2/22/06 USDA Policy Memorandum
  10. Direct Verification - Reauthorization 2004; Implementation Memo11/18/05 USDA Policy Memorandum #06-01
  11. Verification Non-Response Rates for Large School Districts 9/19/05 USDA Policy Memorandum #05-32
      • List of Large School Districts - Please print to view
  12. Verification Activities: Reauthorization 2004 Implementation 3/25/05 USDA Policy Memorandum #05-17
  13. Effect of Current Verification Activity on SY 2005-2006 Verification Requirements: Reauthorization 2004 11/30/04 USDA Policy Memorandum #05-06
  14. Verification of Income Eligibility, 9/1/04 USDA Policy Memorandum #04-30
  15. Other DPI Mailing(s) on this subject
  
  
  

Other Forms and Documents

• Calendar of School Nutrition Requirements
• Calendar of School Nutrition Requirements for RCCI's
• Alternate to the Point of Service Meal Counting System
• Appeal Procedures for School Nutrition Programs
• Civil Rights Compliance Self-Evaluation Form - This is the form that can be downloaded and filled in electronically.
• Daily Menu Production Plan
• Edit Check Required for School Lunch Programs
• Coordinated Review Effort (CRE); National Average Daily Attendance and CRE 2009-2010 School Calendar (Optional Form 3) - July 8, 2009
• On-site Monitoring Documentation for Agencies With More Than 1 School - For Tickets, Automated or Check-off List Systems, Updated March 2006.
• Prototype Joint Agreement To be used when a school agency purchases meals from another school agency.
• Reimbursement Rates for School Nutrition Programs
  • School Year 2009-2010
  • School Year 2008-2009
• Fiscal Year 2009 This data report provides school fiscal year enrollment figures including the number of children approved for free/reduced price meals and the % of children approved for free/reduced price meals in Wisconsin public schools. This information is used in the determination of Tier I eligibility for Family Day Care Homes and Summer Food Service Program sites. If you are unable to open the Excel file, please contact Barb Douglas for a copy.

For questions about this information, contact Julie A. Cox (608) 267-9206

Last updated on 10/20/2009 10:59:36 AM