Dept of Education Logo
Dept of Education Logo
Home | About Us | Accountability/Assessment | Certification | Data Collection & Reports | Innovations | Legislation/Hearings/Rules | NH Schools | Professional Development | Employment Opportunities | Contact Us | Search | Calendar
Department of Education - an official New Hampshire Government website
Smaller text size Reset text size Larger text size
skip navigation
students artwork

National School Lunch Program Application Materials

All forms have been changed. Last year's documents will not be accepted.

Forms that must be returned to the State Office
2013 National School Lunch Program Attachments
National School Lunch Program Timeline Timeline Acrobat Reader
NSLP Application Checklist Checklist Acrobat Reader
Attachment A - National School Lunch Program Attestation Form Attachment A Word document
Attachment B - Parent Letter and Parent Income Application for Lunch, Breakfast and Snacks (Free and Reduced) Attachment B Word document
Attachment C - Special Milk Application and Parent Income Application (If applicable) Attachment C Word document
Attachment D - After School Snack Program Application (If applicable) Attachment D Word document
Attachment E - State of NH Federal Meals Program Wellness Documentation Attachment E Word document
Attachment F - Ethnic/Racial Data Form (completed by RCCI's and Non-Public Schools only) Attachment F Word document
Attachment G - List of Board Members (completed by RCCI's and Non-Public Schools only) Attachment G Word document
Attachment H - Procurement and Food Service Management Compancy Declaration Issue Attachment H Word document
Attachment J - Computerized System for Verifying Free and Reduced-Price Parent Income Applications [NEW] Attachment J [NEW] Word document
Attachment K - NSLP Paid Lunch Equity (PLE) Attestation [NEW] Attachment K [NEW] Word document
NSLP Permanent Agreement (For NEW SAUs/RAs ONLY) Perm Agree Word document
Parent Appeal Rights Parent Appeal Word document
Forms for School Food Authority Use
Attachment L - Procurement Procedures Declaration Page Attachment L Word document
Attachment M - Notification of Eligibility Determination Attachment M Word document
Attachment N - Sharing of Information with Other Programs Attachment N Word document
Attachment O - Free and Reduced School Meals Application/Eligibility Disclosure Requirement Programs (In-House Document for SAU's) Attachment O Word document
Attachment P - Determining Official Income Guidelines Attachment P Acrobat Reader
Attachment Q - 50% Eligibility List NSLP ONLY Attachment Q Acrobat Reader
Attachment R - Administrative Appeal Procedures Attachment R Acrobat Reader
Attachment S - Notice of Direct Certification Attachment S Word document

Income GuidelinesRates for Reimbursement
FY 2014
(07/01/13 - 6/30/14)
Acrobat Reader FY 2014
(07/01/13 - 6/30/14)
Acrobat Reader

FY 2013
(07/01/12 - 6/30/13)

Acrobat Reader FY 2013
(07/01/12 - 6/30/13)
Acrobat Reader
FY 2012
(07/01/11 - 06/30/12)
Acrobat Reader FY 2012
(07/01/11 - 06/30/12)
Acrobat Reader
FY 2011
(07/01/10 - 6/30/11)
Acrobat Reader FY 2011
(07/01/10 - 06/30/11)
Acrobat Reader
FY 2010
(07/01/09 - 06/30/10)
Income Guidelines FY 2010, Acrobet Reader FY 2010
(07/01/09 - 06/30/10)
Rates for Reimbursement FY 2010, Acrobat Reader

Microsoft Excel Symbol Microsoft Excel format. You can download a free reader from Microsoft.

Acrobat Reader Symbol Acrobat Reader format. You can download a free reader from Adobe.

Microsoft Word Symbol Microsoft Word format. You can download a free reader from Microsoft.

New Hampshire Department of Education
101 Pleasant Street | Concord, NH | 03301-3494
Telephone: (603) 271-3494 | TDD Access: Relay NH 711