Archimedean Schools Lunch Program: Application for Free or Reduced
General Instructions
  • This form is available in English, Spanish, Creole and Greek
  • Only Applications submitted to Archimedean Schools from this website will be considered
  • Fill out all required fields. (*)
  • One application form per family
  • This application is for school year 2018-2019
  • After submitting, an application number will be generated and emailed to you along with a confirmation
  • If confirmation is not received, please email our lunch program specialist. Email: lunch@archimedean.org
  • Household Definition
PART 1. SNAP/TANF (Formerly Food Stamps)
If you have a SNAP or TANF case number please enter the number here below. Please note a valid case number contains only 10 digits and begins with 10,11,12, 13, 14, 15, or 16. EX: 1200305555
Snap Number:
PART 2. Student Information. Number of Children (*) 
Please enter the number of children in the household above and click "Set". (Include children in different schools)
PART 3. Social Security Number and Adult Information
An adult household member must certify the application. If Part 4 is completed, the adult completing the form must also list his or her Social Security Number or mark the "I do not have a Social Security Number" box.
Adult First Name(*)
Adult Last Name(*)
Email(*)
Daytime Phone Number(*)
SSN (Last 4 digits)XXXX-XX- 
PART 4. Total Gross Household Income from last month (You must list ALL INCOME to qualify)

List all Household Members not listed in PART 2 (including yourself) even if they do not receive income. For each Household Member listed, if they do receive income, report total income for each source, report total income for each source in whole dollars only. If you leave fields blank you are certifying (promising) that there is no income to report. Are you unsure what income to include here?

How many dollars did each person in the household make last month?
(W)= Weekly (E)= Every 2 weeks, (T)= Twice a Month (M)= Monthly (A)= Annual
Enter the name of each household member. Students and Children will automatically populate from the student section above Earnings from work before deductions (GROSS INCOME) Public Assistance, Child Support, Alimony Pension, Retirement, All Other Incomes
First Name Last Name      
Total Number of household members N/A Income: N/A Frequency Annually
EligibilityN/A
Part 5 Digital Signature and compliance affirmations.
YOU MUST ACCEPT BOTH STATEMENTS FOR YOUR APPLICATION TO BE PROCESSED
I certify (promise) that all information on this application is true and that all income is reported. I understand that the school will get Federal funds based on the information I give. I understand that school officials may verify (check) the information. I understand that if I purposely give false information, my children may lose meal benefits, and I may be prosecuted.
By my electronic submission of this application I verify my understanding/agreement with the above statement and all USDA guidelines regarding the Free and Reduced School Lunch Program.
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