Cafeteria Forms
National School Lunch and Breakfast Program
The Pollock Pines Elementary School District takes part in the National School Lunch and School Breakfast Programs. Meals are served every school day. All of our meals meet state and federal nutritional guidelines. Students may buy lunch for $2.50, and/or breakfast for $1.25. Eligible students may receive meals free or at a reduced price of $0.40 for lunch and/or $0.30 for breakfast. Students may buy milk for $0.25, or chocolate milk or juice for $0.50. Adult breakfast is $1.75, and adult lunch is $3.00.
- This district/agency participates in Direct Certification: In a school participating in a meal program, your child is automatically certified to receive free meals if your household currently receives Food Stamp (FS), or if your child receives California Work Opportunity and Responsibility to Kids (CalWORKs), Kinship Guardianship Assistance Payments (Kin-GAP), or Food Distribution Program on Indian Reservations (FDPIR) benefits.
- A foster care child who is the legal responsibility of the welfare agency or ward of the court is eligible to receive meals, free regardless of the household income. Households with foster and non-foster children may choose to include the foster child as a household member, as well as any personal income earned by the foster child, on the same household application that includes their non-foster children. This will streamline the application process and may help the foster family's non-foster children qualify for free or reduced price meals based on household size in income. Foster payments received by the family from the placing agency are not considered income and do not need to be reported. Please note that the presence of a foster child in the household does not convey eligibility for free meals to all children in the household.
- If you do not receive benefits automatically qualifying your child for free meals, you may apply for free/reduced-price meals for your children. If your total household income is the same or less than the amounts on the income scale below, your child may receive meals free or at a reduced price. “Household” means a group of related or non-related individuals who are living as one economic unit and sharing living expenses. “Living expenses” include rent, clothes, food, doctor bills, and utility bills.
Please contact Judy Thoreson at 530-644-5416, if you have any questions regarding the Free and Reduced Lunch programs
INCOME ELIGIBILITY GUIDELINES
FOR FREE AND REDUCED-PRICE MEALS OR FREE MILK
IN CHILD NUTRITION PROGRAMS
(Effective from July 1, 2011 through June 30, 2012)
Participants from households with incomes at or below the following levels may be eligible for free or reduced-price meals or free milk.
|
|
Free Eligibility scaleLunch, Breakfast, Milk |
Reduced-price Eligibility scale Lunch, Breakfast |
||||||||
|
household size |
year |
month |
twice per month |
every two weeks |
week |
year |
month |
twice per month |
every two weeks |
week |
|
1 |
$14,157 |
$1,180 |
$590 |
$545 |
$273 |
$20,147 |
$1,679 |
$840 |
$775 |
$388 |
|
2 |
19,123 |
1,594 |
797 |
736 |
368 |
27,214 |
2,268 |
1,134 |
1,047 |
524 |
|
3 |
24,089 |
2,008 |
1,004 |
927 |
464 |
34,281 |
2,857 |
1,429 |
1,319 |
660 |
|
4 |
29,055 |
2,422 |
1,211 |
1,118 |
559 |
41,348 |
3,446 |
1,723 |
1,591 |
796 |
|
5 |
34,021 |
2,836 |
1,418 |
1,309 |
655 |
48,415 |
4,035 |
2,018 |
1,863 |
932 |
|
6 |
38,987 |
3,249 |
1,625 |
1,500 |
750 |
55,482 |
4,624 |
2,312 |
2,134 |
1,067 |
|
7 |
43,953 |
3,663 |
1,832 |
1,691 |
846 |
62,549 |
5,213 |
2,607 |
2,406 |
1,203 |
|
8 |
48,919 |
4,077 |
2,039 |
1,882 |
941 |
69,616 |
5,802 |
2,901 |
2,678 |
1,339 |
|
For each additional family member, add: |
||||||||||
|
|
$4,966 |
$414 |
$207 |
$191 |
$ 96 |
$7,067 |
$589 |
$295 |
$272 |
$136 |
