Sharing Information With Other Programs
Dear Parent/Guardian:
To save you time and effort, the information you gave on your Free and Reduced Price School Meals Application may be used to provide financial assistance for additional school programs for which your children may qualify. For the following programs, we must have your permission to use your information. Sending in this form will not change whether your children get free or reduced price meals.
- Yes! I DO want school officials to use information from my Free and Reduced Price School Meals Application for Middle School and High School Athletic programs.
- Yes! I DO want school officials to use information from my Free and Reduced Price School Meals Application for school field trips held during the school day.
- Yes! I DO want school officials to use information from my Free and Reduced Price School Meals Application for the Performing Arts Department for a 30-minute private instrument and/or voice lesson.
- Yes! I DO want school officials to use information from my Free and Reduced Price School Meals Application for the Technology Department for use of a school-owned device.
- Yes! I DO want school officials to use information from my Free and Reduced Price School Meals Application for the High School Counseling Department for transcripts and other costs.
- Yes! I DO want school officials to use information from my Free and Reduced Price School Meals Application for the Elementary Before School program.
If you checked yes to any or all of the boxes above, fill out the form below to ensure that your information is shared for the child(ren) listed below. Your information will be used only with the programs you checked.
| Child’s Name: | School: |
| Child’s Name: | School: |
| Child’s Name: | School: |
| Child’s Name: | School: |
| Signature of Parent/Guardian: |
| Date: |
| Printed Name: |
| Address: |
For more information, you may call Sherly Cordero at 781-446-6210 ext. 5632 or e-mail at scordero@wellesleyma.gov.
Return this form as soon as possible to: Wellesley Public Schools, ATTN Sherly Cordero, 40 Kingsbury Street, Wellesley, MA 02481
Printable Forms:
- Free and Reduced Meal Application (PDF)
- Free/Reduced Lunch Information Sharing Authorization (PDF)
- Tip: You may also print this page by clicking Ctrl + P on a PC or Command + P on a Mac.
Additional Information is available on the Financial Assistance Information page.