 Categorical Eligibility ◦ FIP ◦ Food Assistance ◦ Homeless ◦ Migrant ◦ Runaway ◦ Head Start ◦ Foster Child  Income, including foster children with household size  Direct Certification, both paper and electronic

 Food Assistance/FIP Households ◦ Name of children ◦ Food assistance/FIP number needed for the household ◦ Signature  Other households ◦ Names of all household members ◦ Last 4 digits Social security number of adult or ‘none’ indicated in space, if applying based on income ◦ Current regular income by household members ◦ Signature

 Any application that is missing required information, or that contains inconsistent information, or is unclear is considered an incomplete application and cannot be processed!  Approving incomplete applications may result in fiscal action.  The LEA should make an effort to contact the household to obtain or clarify the information.

 Part 1. Check all applicable boxes:   school meals   special milk (restrictions apply)   foster child (ONE APPLICATION PER CHILD)   children in center   Tier I home provider (HP)   Head Start/Even Start   children in home child care (HP)  Provider name: Child care center

COMPLETION OF PART 2 IS REQUIRED

 For Categorical eligibility using case numbers (FIP or Food Assistance) ◦ The case numbers are the same length and usually the same number for clients receiving both. ◦ The case numbers are normally 10 characters long and the first character may be a number or letter and the rest are numbers, sequenced like this:  Example: A  Another Example:

 Only a case number may be used to determine eligibility  Case numbers can be found on the Notice of Decision sent every few months to FIP/Food Assistance participants  The number on the EBT plastic card is NOT the case number!

 DHS tells families to keep this plastic card even if they no longer will receive FIP or Food Assistance, as it can be reinstated later. It is quicker for families not to wait for the new card to come in the mail.

Debit Card # 19 digits NOT THE CASE NUMBER DO NOT ACCEPT

 Know who the Homeless Liaison is in your district! ◦ Homeless Liaison must provide an application or a letter with:  Name of child  Effective date(s)  Residence or shelter where homeless child is staying  Signature of liaison or director of the homeless shelter ◦ Homeless child has year long eligibility ◦ If residing with another family applying for benefits, the homeless child’s name can be included on their application, so the child may appear on two applications

 Know who your Migrant Education Coordinator  State Coordinator is Susan Selby, ,  Migrant Education Coordinator may provide an application or a letter with the: ◦ Name of child ◦ Effective date(s) ◦ Signature of Migrant Education Program Coordinator  Must be checked every year  Cannot be by parent declaration

 Seldom used in Iowa  Contact the local education agency homeless liaison.  If your district does not have a homeless liaison you may contact the state homeless liaison: Sandy Johnson, ,  The Homeless Liaison will be involved declaring the student homeless.

 Head Start enrollees are categorically eligible  Even Start enrollees who attend a federally funded program and are/ have not yet entered kindergarten are categorically eligible  Eligibility is established by a letter or notice by the Head Start or Even Start agency that the child is enrolled and meets criteria  Cannot be by parent declaration – the parent checking the Head Start box on the application does NOT make the child eligible