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Aplicación para Beneficios Alimenticios
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Sharing Information Waiver
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Suspensión para compartir informacion
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885 Siskiyou Blvd
Ashland, OR 97520
Phone: 541-482-2811 Ext. 1116
Contact: Christina Lehman
Email: 
Sharing Information Waiver - English

Dear Parent/Guardian:

The information you give on the Confidential Application for Free or Reduced Price Meal is only used to determine your student(s) eligibility for Free or Reduced Price meals.  The information may also be used to determine your student(s) eligibility to receive benefits for other programs.  For the following programs we must have your permission to share your information.
Sending in this form will not change whether your student(s) get free or reduced meals.
Signing this waiver is NOT A REQUIREMENT for participation in any school nutrition program.

Field Trip Expenses
Basic Student Necessities
Insurance for Athletics & Field Trips
Musical Instrument Rentals
College Placement Tests
Other Fee Waivers may be available.  Check with your school's Office Manager.
  • IF YOU WOULD LIKE TO ALLOW THIS INFORMATION TO BE SHARED FOR THESE PURPOSES, PLEASE PRINT AND FILL IN THE pdf FILE AT THE BOTTOM OF THIS PAGE.
This institution is an equal opportunity provider.
 





Download File
18-19 English Sharing page.pdf

(19.6KB)
 

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