Income Application & Sharing Information Forms

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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  2022-2023 electronically.   The Spanish version can be found here 2022-2023 Formulario de ingresos alternativos del hogar.  
AHI EnglishAHI Spanish

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.

 

Paper forms may be picked up at the Administrative Service Campus or you may print a copy of the application using the links below. 

  • COMING SOON!!!  2022-2023 Alternate Household Income Form - ENG/Spanish

 

Previous Year - Sharing Information with Other Program forms - Printable

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.

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