1500 E. 128th Ave. • Thornton, CO 80241 • Office: (720) 972-4000 / Together – educating the whole child
2014-2015 INFORMATION RELEASE
Dear Parent/Guardian:
To save you time and effort, the information you gave on your Free and Reduced Price School Meals Application may be shared with other programs for which your children may qualify. For the following programs, we must have your permission to share your eligibility status. Sending or not sending in this form will not change whether your children receive free or reduced price meals.
No! I DO NOT want information from my Free and Reduced Price School Meals Application shared with any of these programs.
If you checked no, stop here. You do not have to complete or send in this form. Your information will not be shared.
Yes! I DO want school officials to share information from my Free and Reduced Price School Meals Application with the District for all programs listed below for which he/she is participating. IF YOU CHECK THIS BOX YOU DO NOT NEED TO CHECK ANY OF THE BOXES BELOW.
Yes! I DO want school officials to share information from my Free and Reduced Price School Meals Application with the District for the purpose of waiving District Fees.
Yes! I DO want school officials to share information from my Free and Reduced Price School Meals Application with the District for the purpose of waiving School Fees.
Yes! I DO want school officials to share information from my Free and Reduced Price School Meals Application with the District for the purpose of waiving Class Fees.
Yes! I DO want school officials to share information from my Free and Reduced Price School Meals Application with the District for the purpose of waiving Athletic and Extracurricular Fees.
Yes! I DO want school officials to share information from my Free and Reduced Price School Meals Application with the District for the purpose of waiving Transportation Fees.
Yes! I DO want school officials to share information from my Free and Reduced Price School Meals Application with the District for the purpose of waiving Exam Fees.
Yes! I DO want school officials to share information from my Free and Reduced Price School Meals Application with the District for the purpose of encouraging and assisting with post-secondary planning, assistance and enrollment.
If you checked yes to any or all of the boxes above, fill out the information below. Your information will be shared only with the programs you checked. (Your personal information will not be shared.)
Child’s Name: ______School: ______
Child’s Name: ______School: ______
Child’s Name: ______School: ______
Child’s Name: ______School: ______
Signature of Parent/Guardian: ______Date: ______
Printed Name: ______
Address: ______
Return this form to your school office.