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Lunch Application

Program Materials for Free & Reduced Price School Lunch Meals

National School Lunch Program

Evergreen School District offers free or reduced price meals to those students who qualify. Federal, State, Title 1 and private grant funding is based on the number of eligible meal applications we collect and process. We encourage all households to complete a meal application, even if you plan on sending lunch from home for your student. You can help our schools obtain additional funding to ensure children in our district continue to receive fundamental services just by completing the form.

Applications may be submitted anytime during the school year and households are encouraged to complete a new application if you experience a decrease in household income, become unemployed, have an increase in family size, or qualify for CalFresh, MediCal, AFDC, CalWorks, Kin-GAP, or FDPIR benefits.

Evergreen School District encourages all families to apply online for Free and Reduced Price Meals. The process is SAFE, SECURE, PRIVATE, and AVAILABLE anytime, anywhere!


Safe & Secure

We use the highest level of data encryption available, meaning that your information is always safe and guarded.

Private & Available

Apply online in the comfort and privacy of your own home.The online service is available 24/7 anytime, anywhere there is an Internet connection!

Fast

Your data is transmitted to the Evergreen School District Child Nutrition Office the same day you apply, allowing for quicker processing so you can receive benefits faster.

Go Green

No more paper applications to complete and return to the school office! Applying online is so convenient and good for the environment as well!



Important Note to Families:

Child Nutrition Services is GREEN in EVERGREEN!

In an effort to reduce environmental impact and process applications in a faster more efficient way, no paper applications will be mailed home.

Families can complete their application online at www.heartlandapps.com. If a hard copy application is needed, applications can be requested from your child’s school office, at the Evergreen Child Nutrition Services office located at 2828 Corda Drive, San Jose CA 95122 or print them at home using the links below. Don’t have a computer? Computers are available for public use free of charge at any San Jose Public Library. You can call ahead to verify the library hours of operation. Or complete the application using your mobile smart-phone (Data rates may apply. Please check with your cell phone carrier).


2017-18 Free & Reduced Lunch Application - English

How to Apply for Free & Reduced Price Meals - English


2017-18 Free & Reduced Lunch Application- Spanish

How to Apply for Free & Reduced Price Meals - Spanish


2017-18 Free & Reduced Lunch Application- Vietnamese

How to Apply for Free & Reduced Price Meals - Vietnamese


If you would like to apply for the program using a hard copy application, please carefully follow the instructions and return the application via the mail to:

Child Nutrition Services
2828 Corda Drive
San Jose, CA 95122

or return the completed application to your student’s school. Only ONE application needs to be completed for each household. Please review the information prior to submitting application to ensure all required areas have been completed. Applications that are incomplete will be returned and the eligibility process will be delayed. An original copy with signature must be received for processing. It cannot be submitted by fax.

Please check the application for the following:

            • All Student Names and Attendance School
            • All other children in the household
            • Names of all adult household members
            • Income information for ALL household members
            • Source of income
            • Signature of parent or guardian
            • Last four digits of the Social Security of the signing adult

A new application must be submitted and processed prior to October 5, 2017 for your students to qualify for the 2017/2018 school year. If you were qualified for the Free/Reduced Lunch Program last year, you will remain eligible at the same status until your 2017-2018 application is processed. If your application is submitted after the October 5, 2017 cutoff date your student(s) qualification will change to paid status. A new application MUST be completed each school year. You will be responsible for any charges to your student’s account during the approval process or during any period that your student(s) qualification lapses.

Households who receive Food Stamps, CalWORKs or MediCal for their students and have received a letter stating their students are directly certified DO NOT have to complete an application. A letter will notify you of your child’s eligibility and your child will automatically receive free lunches unless you notify the CNS office that you do not want the benefits. If you have not received a letter by August 21, 2017 indicating that your child is qualified, please complete a lunch application and return it to your child’s school.

If you have any questions, call the Child Nutrition Services office at 223-4500.



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: , 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:

(1) mail: U.S. Department of Agriculture

Office of the Assistant Secretary for Civil Rights

1400 Independence Avenue, SW

Washington, D.C. 20250-9410;

(2) fax: (202) 690-7442; or

(3) email: program.intake@usda.gov <mailto:program.intake@usda.gov>.

This institution is an equal opportunity provider


CNS

Supervisor Lida Gaines 

2828 Corda Drive
San Jose, CA 95122-1506
(408) 223 - 4500 (Phone)
(408) 223 - 4507 (Fax)

Evergreen School District

  • 3188 Quimby Road
  • |
  • San Jose, CA 95148
  • |
  • Phone: 408-270-6800
  • |
  • Fax: 408-274-3894
  • |
  • info@eesd.org
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