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    UniformApp English1 PreK-8

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    Simón Bolívar
    This document is a uniform assistance application for a school. It collects information about students such as their name, ID number, grade, birthdate, whether they receive free or reduced lunch, and shirt and pants sizes. It also collects contact information for parents such as their name, address, and phone numbers. The application notes that information provided will be kept confidential and used only to verify eligibility for assistance. It requires signatures from parents and the school principal to verify and process the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    UniformApp English1 PreK-8

    Uploaded by

    Simón Bolívar
    45 views1 page
    This document is a uniform assistance application for a school. It collects information about students such as their name, ID number, grade, birthdate, whether they receive free or reduced lunch, and shirt and pants sizes. It also collects contact information for parents such as their name, address, and phone numbers. The application notes that information provided will be kept confidential and used only to verify eligibility for assistance. It requires signatures from parents and the school principal to verify and process the application.

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    © © All Rights Reserved

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    This document is a uniform assistance application for a school. It collects information about students such as their name, ID number, grade, birthdate, whether they receive free or reduced lunch, and shirt and pants sizes. It also collects contact information for parents such as their name, address, and phone numbers. The application notes that information provided will be kept confidential and used only to verify eligibility for assistance. It requires signatures from parents and the school principal to verify and process the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    45 views1 page

    UniformApp English1 PreK-8

    Uploaded by

    Simón Bolívar
    This document is a uniform assistance application for a school. It collects information about students such as their name, ID number, grade, birthdate, whether they receive free or reduced lunch, and shirt and pants sizes. It also collects contact information for parents such as their name, address, and phone numbers. The application notes that information provided will be kept confidential and used only to verify eligibility for assistance. It requires signatures from parents and the school principal to verify and process the application.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    REVISED: 8/18/06

    FAMILY INFORMATION (PLEASE PRINT IN INK):


    PARENT/GUARDIANS
    NAME:

    HOME ADDRESS: ZIP CODE:
    HOME PHONE:

    UNIFORM
    ASSISTANCE
    APPLICATION
    WORK/OTHER PHONE:

    STUDENT INFORMATION (PLEASE PRINT):
    FOR USE BY
    SCHOOL STAFF
    ONLY

    STUDENT
    ID NUMBER
    NAME OF STUDENT
    LAST FIRST MIDDLE

    BOY/
    GIRL GRADE
    DATE OF
    BIRTH
    Free or
    Reduced
    Lunch

    Y/ N
    SHIRT/
    BLOUSE
    SIZE
    PANTS/
    SKIRT
    SIZE

    DATE
    UNIFORM
    DISTRIBUTED




















    For Use by School Staff Only

    1. Verify Student ID #for each student.
    2. Verify family information and student's enrollment.
    3. Ensure completeness of application, signature, and date.
    4. Keep the original, give a copy to the parent

    I certify that all information I have submitted on this application is true and accurate. I
    understand that if any fraud is detected or suspected I will be reported immediately to the
    Police and Security Services Department. I herein authorize campus staff to access
    information on my application for free/reduced lunch to verify my need for assistance.
    This information should not be shared nor used for any other purpose.


    Date Received on Campus:

    Student Information Verified by:

    Signature of parent/guardian Date


    Principal's Signature:

    Date of uniform order: Date of order receipt:
    SCHOOL NAME:

    (No Social
    Security
    Numbers)
    Not-Approved Approved
    PreK-8 ONLY

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