SAMPLE LETTER TO PARENTS

ENROLLED PROGRAMS, RESIDENTIAL/DAY CAMPS, AND CONDITIONAL NON-CONGREGATE SITES

Dear Parent or Guardian:

We are planning to seek assistance for food service under the Summer Food Service Program for Children.  This program is funded by the U.S. Department of Agriculture and administered by the Maine Department of Education. 

Our program can receive reimbursement for meals served to children meeting the eligibility criteria for free or reduced-price school meals.  We must document the eligibility of these children by obtaining family size and income data.
Completing the Application – In order to be considered eligible for free meals, an application must contain complete documentation of eligibility information.  The information must include the total current household income, names of all household members, the last four digits of the social security number of all adult household members, and the signature of an adult household member.  Sponsors may verify the source and amount of income as well as household members.  Children who are members of Food Stamp households or TANF assistance units are automatically eligible to receive free meals and do not need to provide family size or income data.  However, they must provide their Food Stamp or TANF case number.

We would appreciate your completing the attached application.  Any information given is maintained in strict confidence.  You may call or write us if you have further questions.

Director of Sponsoring Organization___________________________________________________________________

Address_______________________________________________________________________

Phone Number__________________________________________________________________

Sincerely,

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.
The Maine Human Rights Act prohibits discrimination because of race, color, sex, sexual orientation, age, physical or mental disability, genetic information, religion, ancestry or national origin.
Complaints of discrimination must be filed at the office of the Maine Human Rights Commission, 51 State House Station, Augusta, Maine 04333-0051. If you wish to file a discrimination complaint electronically, visit the Human Rights Commission website at https://www.maine.gov/mhrc/file/instructions and complete an intake questionnaire. Maine is an equal opportunity provider and employer.