Introduce the Low Income Form… Low Income Form In accordance with the guidelines, does your household qualify for Free Lunch, Reduced Lunch, or neither? Free Lunch Reduced Lunch Does not qualify for Free or Reduced LunchFamily Name Address Line 1 Address Line 2 City State ZIP Code All Children in Household Name of Child Grade Public School District of Residence Assigned Public School of Attendance By signing below I verify the information I have given on this form I agree to sign electronically pursuant to the Electronic Signature Disclosure.Signature Sign Here Submit Form
