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Instructions for completing the

2008-2009 Family Application for Meal Benefits

(Complete ONE application per HOUSEHOLD, unless you are applying for Foster Children, or have some children receiving Food Stamps)

Please read carefully: An incomplete application cannot be processed. Benefits will not begin until the application has been processed in the main office of the Food Service Department.

For assistance in completing the application, please call 1-800-819-7556

                                                 
       
Only one application needed per household except for households with foster children. Submit a separate application for each foster child.
           
                                                 
              If you receive FOOD STAMPS:                      
            Section 1Section 2Section 6Section 7Section 9          
  • You must complete sections:
         
  • The adult Social Security Number is not required.
  • You MUST provide your Food Stamp/TANF Household Case Number (NOTE: This is not your Nevada Quest Card Number).
  • You must provide the 6 or 7 digit unique Student Identification Number that was assigned when you enrolled your child(ren) in school.
PLEASE NOTE: if all children in the household are not assigned a Food Stamp/TANF Number you MUST complete the entire application.
 
        If you are applying for a FOSTER CHILD:    
Section 1Section 3Section 4Section 6Section 7Section 9
  • You must complete sections:
 
  • List only one foster child per application.
             
  • The adult Social Security Number is not required
         
  • List any personal income recieved by the Foster Child ( indicate $0 if they have no income ).
                                         
For all other applicants, complete the following sections of the application:
Section 1
List all students attending Clark County School District

Section 3
List student's Monthly Gross Income or check the "No Income" box. This is not the Adult Household Member's Income.
Section 5
List all other household members and monthly gross income
Sectioin 6 Section 1 Section 5
Total ALL household members in sections &  
Section 7
Mark Racial Identity
Section 10
Complete Social Security Number, address, and telephone number. Mark the Box if you do not have a Social Security Number
Section 9
Sign and Date the application
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WARNING!

DO NOT PRINT THIS APPLICATION. It is for instructional purposes only. Applications are available at elementary, middle, outlying high schools, most local highschools and at the main office of the Food Service Dept. at 6350 E. Tropical, Las Vegas, NV.
For more information please call 1-800-519-7556

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SCHOOL CODE: Enter the 3-digit school code for the school the student will be attending. This code can be found from the list on the inside of the 2008-2009 Child Nutrition Program School Meal Packet. Enter only one digit per box. FOOD STAMP CASE # OR TANF: Enter the number assigned by the state, one digit per box. STUDENT'S MONTHLY INCOME: Enter the total income the student recieves from all sources for the month.
BIRTHDATE: Enter the student's birthdate in this area, using 2 digits for the month, day, and year. For example, January would be entered as 01. The 3rd of the month would be entered as 03.
STUDENT ID#: Insert the District assigned six or seven digit student number, one digit per box. STUDENT NAME: Insert the student'sfirst name, middle initial, and last name in this area. One letter per box. Please use the student's legal name that was used to register the student in the school district. Use of nicknames or contractions will prevent us from matching the application with the student database, and may result in a denial of benefits. GRADE: Enter the numeric grade the student will be participating in this year. For 1st grade through 9th enter a zero in the first box, and the grade number in the second. For example, 7th grade would be entered as 07.
FOSTER CHILD: If the student is legally defined FOSTER CHILD, check this box and follow the instructions immediately following the check box.
OTHER HOUSEHOLD MEMBERS: In this area list all the other members of the household, one per line. If this member has no income at all, check the box of NO INCOME; otherwise, list member's income (per payday), and mark how often they are paid in a month, in teh appropriate circle.
TOTAL HOUSEHOLD MEMBERS: Enter the total number of the members in this household. This total should equal the number of names entered on the application. NOTE: if this application is for a FOSTER CHILD, enter a 01. RACIAL / ETHNIC IDENTITY: Please check the appropriate racial and ethnicidentity of the student.
SOCIAL SECURITY NUMBER: You MUST enter the social security number of the adult filling out this application. If you do not have a social security number, you MUST check the box. SIGNATURE: The adult household member filling out this application MUST sign the application in this box. DATE: Please enter the date the application is completed.
ADDRESS & PHONE NUMBER: Please write in your mailing address and telephone numbers. These will be used to contact you if there are any questions about your application.

 
 

 

This information is brought to you by the dedicated employees of the Clark County School District Food Service Department.

"Fuel for Student Achievement "