Parent/Guardian Economic Status Form

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This form will provide information needed by the Maine Department of Education to determine

RSU #74 ‘s eligibility status for State Economically Disadvantaged funds available under the Essential Programs & Services Funding Act and other grants and programs in our schools. Data in this form will not be used for school lunch purposes, but only to determine various funding amounts used in your student’s school and districtwide. If you have any questions, please call Tammy Conners at 635-2727 Ext. 5. The due date to return this form to your school office is September 16, 2022. Thank you for your cooperation.

Please use the table below as guidance to determine your student’s economic status. If household income is less than the Annual or Monthly earnings for your household size in the chart below, then your student meets the economic disadvantaged status criteria. Household size includes adults and children.

My household meets the REDUCED Category Guidelines

My household meets the FREE Category Guidelines

My household is NOT eligible

Parent / Guardian Name (First & Last) *

Name of RSU #74 Student (First & Last) *

Grade the student will be going into for the 22-23 school year *

School Child will be attending *

I have more children that I need to enter in names for *

Yes

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