• Consent to Release
    Free & Reduced Meal Information
     

     

    In accordance with the USDA's National School Lunch Act we must obtain parents/guardians permission to release student(s) meal status and share student(s) meal status for the following FREE & DISCOUNT programs. Completing the form below will not change the meal status for your student(s).


    Place an "X" in the box to indicate which programs YOU DO want Lake County Schools Food Service Officials to share your student(s) Free or Reduced meal status with.

    English Consent to Share    Consentimiento para compartir
       
    It will be the parents/guardians responsibility to provide the Eligibility Notification Letter for Free & Reduced Meals to any other programs that are not listed or Consent to Share form as well as the Consent to Share forms that are not received.

    In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

    Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English. 

    To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

     

    mail:     U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights
                1400 Independence Avenue, SW
                Washington, D.C. 20250-9410

    fax:     (202) 690-7442; or

    email:  program.intake@usda.gov.

     

    This institution is an equal opportunity provider.