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Beginning of the Year
Free and Reduced Price Application Procedures

Each sponsor must assemble and maintain on file a completed copy of each of the forms listed below:

Attention:  It is OK to send out this years forms even if Sponsor Application/Renewals have not been approved.

Form Number and Name


Income Eligibility Guidelines 2013-14pdf icon

DO NOT SEND THIS TO PARENTS - this is to be used only by the determining official.

Letter to Households pdf icon

Distribute along with the Application for Free and Reduced Price Meals to the households of all enrolled students.

Application for Free and
Reduced-Price Meals

Any change in this application must have prior approval from our office.

Notification Letter

Households must be notified of the eligibility determination.  Households denied benefits must be given written notification of the denial.  The school may include additional information, but all items from the prototype must be included.

Change in Benefits

This letter (or an approved alternate) must be used when the school's verification efforts result in a change in determination from the originally approved application.  (Charge Programs Only).

Meal Counting/Claim Preparation (SFN 9188)

Complete and return one copy of this form ONLY if the system of meal counting/claim preparation has been altered.

**Forms to locate & pull forward to new school year file: Program Agreement (SFN 5908), Policy Statement for Free & Reduced Price Meals (SFN 9184) and Meal Counting and Claim Preparation (SFN 9188).

Our office will send the public release to each county's official newspaper and will list all participating schools in the county.  If the school wishes to submit a public release to a newspaper other than the designated county paper, please contact our office. 

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North Dakota Department of Public Instruction
Kirsten Baesler, State Superintendent
600 E. Boulevard Avenue, Dept. 201
Bismarck, North Dakota 58505-0440

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