Income Eligibility Forms 2015-2016
If you wish to apply or reapply for Tier 1 (Higher) reimbursement, please fill out and return the appropriate form. Contact the 4-C CACFP office with any questions.
See the list below for current tier 1 eligible schools.
Provider Household Income Form
Provider Household Income Application
Use this form if you wish to apply for tier 1 reimbursement based on your own household income.
School or Census Application
Use this form if you wish to apply for tier 1 reimbursement based on your school or census area.
Parent/Guardian Household Income Eligibility
Distribute this form to all families in your care.