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School Nutrition Program - Non-Participating Sponsor Document
September 10, 2020
Dear Parent or Guardian:
All students enrolled in New Jersey public schools must be surveyed to determine the percentage of students who qualify for free and reduced price school meals. This survey is necessary even if the school does not participate in any of the federally funded Child Nutrition Programs.
Attached is an application to be used for survey purposes. Please fill out this application, sign it and return it to the Verona Board of Education, Business Office, 121 Fairview Avenue, Verona, NJ 07044 attention Edward Appleton, by October 1, 2020.
New Jersey is committed to ensure that all children are enrolled in a health insurance program. Information on your meal application will be shared with NJ Family Care to determine if your children qualify to participate in this state insurance program. If you do not wish to share your information with Medicaid or NJ Family Care you must complete and sign the enclosed information sharing form for Medicaid or NJ Family Care, and return it by October 1, 2020 to:
Verona Board of Education
Attn: Edward Appleton
121 Fairview Avenue
Verona, NJ 07044
Contact information for NJ Family Care is listed below:
NJ Family Care http://www.njfamilycare.org 1-800-701-0710
Please contact your child’s school if you have any questions. Thank you for your cooperation.
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.
Persons with disabilities who require alternative means of communication for program information (e.g. Braille,large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800)877-8339. Additionally, program information may be made available in languages other than English.
To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://ascr.usda.gov/complaint.filing.cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaints form, call (866) 632-9992. Submit your completed form or letter 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;
(2) fax: (202) 690-7442: or
(3) email: email@example.com.
This institution is an equal opportunity provider.