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Get Hoosier Academy Or Reduced Meal App Form

CORP. NUMBER APPLICATION FOR FREE OR REDUCED PRICE MEALS AND OTHER BENEFITS Part 1. NAME OF CHILD (First Name, MI, Last Name) Effective July 1, 2005 - One Application per Household LIVING WITH CHECK PARENT or BIRTH SCHOOL GRADE IF A CARETAKER DATE FOSTER RELATIVE CHILD Ex: 10/8/2009 YES - NO YES - NO YES - NO YES - NO YES - NO TANF or Food Stamps Case # (If you receive both benefits, list the TANF Case #) YES - NO If ALL children listed above are foster childr.

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