Household Guide

1
Food and Nutrition Services Department 7720 West
Oakland Park Boulevard, Suite 304 Sunrise,
Florida 33351 Phone [phone] or outside
Broward County 1-866-754-2973 E-mail
freereducedmeals_at_browardschools.com for
assistance
Broward County Public Schools
2
Table of ContentsSelect the link below that
applies to your household!

• Income Based Application Instructions.3-12
• Food Stamp/TANF Application Instructions..13-21
• Foster Child Application Instructions.22-31
• (A foster child is considered a household
  of one. No one else is to be listed on the
  application.)
• Homeless, Runaway, or Migrant Application
  Instructions32-42

3
HOW TO COMPLETE THE MULTI-CHILD APPLICATION FOR
MEAL BENEFITS
Income Based Instructions
COMPLETE ONLY ONE APPLICATION FOR ALL CHILDREN
LIVING IN YOUR HOUSEHOLD, EVEN IF THEY ATTEND
DIFFERENT SCHOOLS. USE BLACK INK ONLY AND PRINT
ALL INFORMATION NEATLY.
4
Part 1 New To Broward County Schools
X
Check the box if any of the children are new to
Broward County Schools.
New to Broward County Schools This is a child
who is entering Broward County Public Schools for
the first time or previously attended a Broward
County Public School, withdrew and is returning
at the start of the new school year.
New students will not have a prior year
eligibility. Please provide your child with a
bagged lunch or money to purchase meals until his
or her application is processed.
5
Part 2 Income Based Application-Student
Information
0601234567
Kathy
A
Smith
03 01 98
03
1234
X
0600123456
John
P
Smith
12 20 96
05
1023
X

• Complete the following information
• Student Number
• First Name, Middle Initial, Last Name
• Birth Date, Grade, Location Number
• Skip the Food Stamp/TANF number box
• Check the No Income box if the student has no
  income or enter the
• students gross income check how often the
  income is
• received (Monthly, Twice a Month, Every other
  Week or Weekly)
• Do not list students attending a College or
  University in Part 2

6
Part 3 Household Members and Income
Complete the following information List the
first and last name of all household members that
are not listed in Part 2 do NOT list the
students from Part 2 again in Section 3.

John R. Smith
1150
00

Mary L. Smith
625
50
Tom P. Smith
X
7
Part 3 Household Members and Income Continued
Check the No Income box or list each household
members income how often the income is
received (Monthly, Twice a Month, Every other
Week or Weekly).

John R. Smith
1150
00

Mary L. Smith
625
50
Tom P. Smith
X
All income listed must be the amount received
before taxes and deductions.
8
Part 4 Social Security Number
Enter the complete 9 digit Social Security Number
of the adult household member completing the
application or check the box indicating the adult
does not have a Social Security Number.
9
Part 5 Optional Categories
The following 2 categories are optional and will
not affect your childs meal eligibility.
1 Educational Programs If you do not want
this application to be used in determining your
childs eligibility in other educational
programs, you must check the box provided.
2 Health Insurance The information on this
form can be shared with Medicaid or Florida
KidCare Program. For more information about
health insurance for your child, call
954-467-4885 or 954-467-8737 (Para Español).
10
Part 6 Signature and Contact Information

• Sign and date the application
• All applications must be signed or they will be
  returned home for a signature. This may delay
  meal benefits for the student.
• List current address and phone numbers

John R . Smith
7/6/09
SMITH
Sunrise
954-123-4567
754-123-4567
1234 Oak Street
33351
11
EXAMPLE INCOME APPLICATION
0601234567
Kathy
A
Smith
03 01 98
1234
X
03
0600123456
John
P
Smith
12 20 96
1023
X
05
John R. Smith
1150
00
Mary L. Smith
625
50
x
Tom P. Smith
4 5
6 7 8 9
1 2 3
John R. Smith
7/6/09
SMITH
954-123-4567
754-123-4567
1234 Oak Street
Sunrise
33351
12
Please ensure that all the required information
is completed on the application! For
assistance, call the Food and Nutrition Office at
754-321-0250 or outside of Broward County
1-866-754-2973. E-mail freereducedmeals_at_browardsc
hools.com For Assistance THANKS AND HAVE A GREAT
SCHOOL YEAR!! Return To Table of Contents
13
HOW TO COMPLETE THE MULTI-CHILD APPLICATION FOR
MEAL BENEFITS
Food Stamp/TANF Application Instructions
COMPLETE ONLY ONE APPLICATION FOR ALL CHILDREN
LIVING IN YOUR HOUSEHOLD, EVEN IF THEY ATTEND
DIFFERENT SCHOOLS. USE BLACK INK ONLY AND PRINT
ALL INFORMATION NEATLY.
14
Part 1 New To Broward County Schools
X
Check the box if any of the children are new to
Broward County Schools.
New to Broward County Schools This is a child
who is entering Broward County Public Schools for
the first time or previously attended a Broward
County Public School, withdrew and is returning
at the start of the new school year.
New students will not have a prior year
eligibility. Please provide your child with a
bagged lunch or money to purchase meals until his
or her application is processed.
15
Part 2 Food Stamp/TANF Based Application-Student
Information
0601234567
Kathy
A
Smith
03 01 98
03
1234
1223344598
0600123456
John
P
Smith
12 20 96
05
1023
1123456789

• Complete the following information
• Student Number
• First Name, Middle Initial, Last Name
• Birth Date, Grade, Location Number
• Enter a current Food Stamp/TANF 10 digit case
  number next to
• each childs name. The 10 digit case number
  starts
• with 10, 11, 12, or 13
• Skip the Student/Foster Child No Income and
  Income boxes
• Do not list students attending a College or
  University in Part 2

16
Part 3 Household Members and Income
Please do not fill out this section.
17
Part 4 Social Security Number
Social Security Number is not required when
completing the application.
18
Part 5 Optional Categories
The following 2 categories are optional and will
not affect your childs meal eligibility.
1 Educational Programs If you do not want
this application to be used in determining your
childs eligibility in other educational
programs, you must check the box provided.
2 Health Insurance The information on this
form can be shared with Medicaid or Florida
KidCare Program. For more information about
health insurance for your child, call
954-467-4885 or 954-467-8737 (Para Español).
19
Part 6 Signature and Contact Information

• Sign and date the application
• All applications must be signed or they will be
  returned home for a signature. This may delay
  meal benefits for the student.
• List current address and phone numbers

John R . Smith
7/6/09
SMITH
Sunrise
954-123-4567
754-123-4567
1234 Oak Street
33351
20
EXAMPLE FOOD STAMP OR TANF APPLICATION
0601234567
Kathy
A
Smith
03 01 98
1234
1223344598
03
John
P
Smith
12 20 96
1023
1123456789
05
0600123456
7/6/09
SMITH
Mary L. Smith
954-123-4567
754-123-4567
1234 Oak Street
Sunrise
33351
21
Please ensure that all the required information
is completed on the application! For
assistance, call the Food and Nutrition Office at
754-321-0250 or outside of Broward County
1-866-754-2973. E-mail freereducedmeals_at_browardsc
hools.com For Assistance THANKS AND HAVE A GREAT
SCHOOL YEAR!! Return To Table of Contents
22
HOW TO COMPLETE THE MULTI-CHILD APPLICATION FOR
MEAL BENEFITS
Foster Child Application Instructions
A Foster Child is considered a household of one.
No one else is to be listed on the
application. USE BLACK INK ONLY AND PRINT ALL
INFORMATION NEATLY.
23
Part 1 New To Broward County Schools
X
Check the box if any of the children are new to
Broward County Schools.
New to Broward County Schools This is a child
who is entering Broward County Public Schools for
the first time or previously attended a Broward
County Public School, withdrew and is returning
at the start of the new school year.
New students will not have a prior year
eligibility. Please provide your child with a
bagged lunch or money to purchase meals until his
or her application is processed.
24
Part 1 Foster Child
X

• Check the Foster Child box.
• A Foster Child is considered a household of
• one. No one else is to be listed on the
  application.
• The foster parent should complete and sign the
• application.
• Complete ONE application for each Foster Child
  living
• in your household.

25
Part 2 Foster Child Application-Student
Information

0601234567
Kathy
A
Smith
03 01 98
03
1234
40
00

• Complete the following information
• Student Number
• First Name, Middle Initial, Last Name
• Birth Date, Grade, Location Number
• Skip the Food Stamp/TANF box
• Check the No Income box if the Foster Child has
  no personal use
• income
• Enter the Foster Childs personal use income
  check how often the
• income is received (Monthly, Twice a Month,
  Every other Week or Weekly)

26
Part 3 Household Members and Income
Please do not fill out this section.
27
Part 4 Social Security Number
Social Security Number is not required when
completing the application.
28
Part 5 Optional Categories
The following 2 categories are optional and will
not affect your childs meal eligibility.
1 Educational Programs If you do not want
this application to be used in determining your
childs eligibility in other educational
programs, you must check the box provided.
2 Health Insurance The information on this
form can be shared with Medicaid or Florida
KidCare Program. For more information about
health insurance for your child, call
954-467-4885 or 954-467-8737 (Para Español).
29
Part 6 Signature and Contact Information

• Sign and date the application
• All applications must be signed or they will be
  returned home for a signature. This may delay
  meal benefits for the student.
• List current address and phone numbers

7/6/09
Mary A. Jones
JONES
Sunrise
954-123-4567
754-123-4567
1234 Oak Street
33351
30
EXAMPLE FOSTER CHILD APPLICATION
X

0601234567
Kathy
A
Smith
03 01 98
1234
40
00
03
7/6/09
Mary A. Jones
JONES
954-123-4567
754-123-4567
1234 Oak Street
Sunrise
33351
31
Please ensure that all the required information
is completed on the application! For
assistance, call the Food and Nutrition Office at
754-321-0250 or outside of Broward County
1-866-754-2973. E-mail freereducedmeals_at_browardsc
hools.com For Assistance THANKS AND HAVE A GREAT
SCHOOL YEAR!! Return To Table of Contents
32
HOW TO COMPLETE THE MULTI-CHILD APPLICATION FOR
MEAL BENEFITS
Homeless, Runaway, or Migrant (Not Immigrant)
Instructions
COMPLETE ONLY ONE APPLICATION FOR ALL CHILDREN
LIVING IN YOUR HOUSEHOLD, EVEN IF THEY ATTEND
DIFFERENT SCHOOLS. USE BLACK INK ONLY AND PRINT
ALL INFORMATION NEATLY.
33
Part 1 New To Broward County Schools
X
Check the box if any of the children are new to
Broward County Schools.
New to Broward County Schools This is a child
who is entering Broward County Public Schools for
the first time or previously attended a Broward
County Public School, withdrew and is returning
at the start of the new school year.
New students will not have a prior year
eligibility. Please provide your child with a
bagged lunch or money to purchase meals until his
or her application is processed.
34
Part 1 Homeless, Runaway, or Migrant- (Not
Immigrant)
X
X
X

• Check the box if the student is Homeless,
• Runaway, or Migrant.
• Homeless, Runaway, and Migrant students
• approved for free meals by the Homeless
• Liaison or Migrant Coordinator of Broward
• County Public Schools are not required to
• complete a meal application.
• If your household falls into one of the
• categories listed above, contact your childs
• school or one of the departments listed below

Broward County Public Schools Homeless/Runaway
Liaison 754-321-2494 Migrant Coordinator -
754-321-1414
35
PART 2 Homeless, Runaway, or Migrant-(Not
Immigrant) Student Information
0601234567
Kathy
A
Smith
03 01 98
03
1234
X
0600123456
John
P
Smith
12 20 96
05
1023
X

• Complete the following information
• Student Number
• First Name, Middle Initial, Last Name
• Birth Date, Grade, Location Number
• Skip the Food Stamp/TANF number box
• Check the No Income box if the student has no
  income or enter the
• students gross income check how often the
  income is
• received (Monthly, Twice a Month, Every other
  Week or Weekly)
• Do not list students attending a College or
  University in Part 2

36
Part 3 Household Members and Income
Complete the following information List the
first and last name of all household members that
are not listed in Part 2 do NOT list the
students from Part 2 again in Section 3.

John R. Smith
1150
00
Tom P. Smith
X
37
Part 3 Household Members and Income Continued
Check the No Income box or list each household
members income how often the income is
received (Monthly, Twice a Month, Every other
Week or Weekly).

John R. Smith
1150
00
Tom P. Smith
X
All income listed must be the amount received
before taxes and deductions.
38
Part 4 Social Security Number
Enter the complete 9 digit Social Security Number
of the adult household member completing the
application or check the box indicating the adult
does not have a Social Security Number.
39
Part 5 Optional Categories
The following 2 categories are optional and will
not affect your childs meal eligibility.
1 Educational Programs If you do not want
this application to be used in determining your
childs eligibility in other educational
programs, you must check the box provided.
2 Health Insurance The information on this
form can be shared with Medicaid or Florida
KidCare Program. For more information about
health insurance for your child, call
954-467-4885 or 954-467-8737 (Para Español).
40
Part 6 Signature and Contact Information

• Sign and date the application
• All applications must be signed or they will be
  returned home for a signature. This may delay
  meal benefits for the student.
• List current address and phone numbers

John R . Smith
7/6/09
SMITH
Sunrise
954-123-4567
754-123-4567
1234 Oak Street
33351
41
EXAMPLE Homeless, Runaway, or Migrant- (Not
Immigrant) Application
X
0601234567
Kathy
A
03 01 98
1234
X
03
Smith
X
0600123456
John
12 20 96
05
1023
P
Smith
John R. Smith
1150
00
x
Tom P. Smith
1 23
45
6 789
7/6/09
John R. Smith
SMITH
954-123-4567
754-123-4567
1234 Oak Street
Sunrise
33351
42
Please ensure that all the required information
is completed on the application! For
assistance, call the Food and Nutrition Office at
754-321-0250 or outside of Broward County
1-866-754-2973. E-mail freereducedmeals_at_browardsc
hools.com For Assistance THANKS AND HAVE A GREAT
SCHOOL YEAR!! Return To Table of Contents