Alternate Household Income Form
Materials and Supply (4K-5), Textbook and Materials (6-12), Instrument Rental, Class fees, Extended Learning fees, AP, IB, PSAT, and ACT Testing Fees (HS only) can only be waived for families who have completed the Alternate Household Income form and Sharing Information with Other Programs form, and are determined to be eligible. If you have been notified that your children automatically qualify for free or reduced meals or submitted a paper application already, please do not submit an online application.
This form must be completed annually from July 1 to June 30, and only one application should be filled out for each household. You may now submit your Alternate Household Income Form 2021-2022 electronically. The Spanish version can be found here 2021-2022 Formulario de ingresos alternativos del hogar.
You may also complete the Sharing Information with Other Programs form electronically for the current and/or previous school years using the links listed below.
- 2021-2022 Sharing Information with Other Programs - English
- 2021-2022 Sharing Information with Other Programs - Spanish
- 2020-2021 Sharing Information with Other Programs - English
- 2020-2021 Sharing Information with Other Programs - Spanish
- 2019-2020 Sharing Information with Other Programs - English
- 2019-2020 Sharing Information with Other Programs - Spanish
- 2018-2019 Sharing Information with Other Programs
- 2017-2018 Sharing Information with Other Programs
- 2016-2017 Sharing Information with Other Programs
- 2015-2016 Sharing Information with Other Programs
Paper forms may be picked up at the Administrative Service Campus or you may print a copy of the application using the links below.
- 2021-2022 Alternate Household Income Form & Sharing Information w/Other Programs - English
- 2021-2022 Alternate Household Income Form & Sharing Information w/Other Programs - Spanish
- 2021-2022 Sharing Information with Other Programs ENG/SPA
Previous Year - Sharing Information with Other Program forms - Printable
- 2020-2021 Sharing Information with Others (Student Fee Waiver)
- 2019-2020 Sharing Information with Others (Student Fee Waiver)
- 2018-2019 Sharing Information with Others (Student Fee Waiver)
- 2017-2018 Sharing Information with Others (Student Fee Waiver)
- 2016-2017 Sharing Information with Others (Student Fee Waiver)
- 2015-2016 Sharing Information with Others (Student Fee Waiver)
Completed paper applications can be turned in to the main office of your child’s school or delivered to the Food Service office at the Administrative Service Center.
Mail completed applications to:
Racine Unified School District
Attn: Finance/Food Service
3109 Mount Pleasant Street
Racine, WI 53404
Once your application has been processed, you will be notified of the result via mail.
USDA Nondiscrimination Statement
In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.
Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.
To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:
1. mail:
U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410; or
2. fax:
(833) 256-1665 or (202) 690-7442; or
3. Email: program.intake@usda.gov
This institution is an equal opportunity provider.
