Application – Income Eligibility
The following forms are used in the process of approving households for meal benefits.
- Attachment A Income Eligibility Guidelines 2025
- Attachment B – Letter to Households 2025
- Spanish Version Attachment B – Letter to Household 2025
- Attachment B-1 – Special Milk Program Letter to Households 2025
- Attachment C – Free and Reduced Price Meal Application 2025
- Spanish Version Attachment C – Free and Reduced Price Meal Application 2025
- Attachment C-1 – Free Milk Application 2025
- Attachment D – Approval-Denial Letter 2025
- Spanish Version Attachment D – Approval-Denial Letter 2025
- Attachment D-1 – Special Milk Program Approval-Denial Letter 2025
- Attachment D-3 – Notice for Change of Benefits 2025
- Spanish Version Attachment D-3 – Notice of Change in Benefits 2025
- Attachment E- Self Employment 2025
- Spanish Version Attachment E – Self Employment 2025
- Attachment I – Onsite Review for Lunch & Breakfast Program
- Attachment I-1 – Onsite Review for Afterschool Snack
- Attachment J – Edit Check Worksheet
- Attachment J for RCCI – Edit Check Worksheet
- Attachment L – Sharing Information Waiver 2025
- Spanish Version Attachment L – Sharing Information Waiver 2025
- Attachment L-1 – Medicaid Sharing Information Waiver 2025
Updated August 15, 2024 9:51am
It is the policy of the Nebraska Department of Education not to discriminate on the basis of sex, disability, race, color, religion, marital status, age, national origin, or genetic information in its educational programs, admission policies, employment, or other agency programs.
