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Financial Assistance Determination Application


Hopkinton Public Schools 

89 Hayden Rowe Street Hopkinton, MA. 01748 

Applicants should read JLB-PRC1 to thoroughly familiarize themselves with the Financial Assistance Program requirements before completing this application.
The application covers a one-year period and you may apply for financial assistance at any time.

The application period for the 2022-2023 school year is open as of March 1, 2022.
Documentation of income is required to determine eligibility and level of assistance. The
documentation of household income includes, but is not limited to the following:
● 2021 IRS Form 1040, Pages 1 and 2 of all adults residing in the household;
● Supplemental Security Income (SSI) and Disability Income;
● Unemployment Compensation and severance pay;
● Alimony and child support agreements;
● Transitional Assistance Letters and Benefits; and
● Pay stubs if there has been a decline in income from the previous tax year.

Definition of Income:
In accordance with the Department of Agriculture’s policy as provided in the Food and Nutrition Service publication Eligibility Manual for School Meals, “income”, means income before any deductions such as income taxes, Social Security Taxes, insurance premiums, charitable contributions, and bonds. It includes the following:

(1) monetary compensation for services, including wages, salary , commissions or fees;
(2 )net income from non-farm self-employment;
(3) net income from farm self-employment;
(4) Social Security;
(5) dividends or interest on savings or bonds or income from estates or trusts; (6) net rental income;
(7) public assistance or welfare payments;
(8) unemployment compensation;
(9) government civilian employee or military retirement, or pensions or veterans payments; (10) private pensions or annuities;
(11) alimony or child support payments; 
(12) regular contributions from persons not living in the
(13) net royalties; and
(14) other cash income. Other cash income would include cash amounts received or withdrawn from any source including savings, investments, trust accounts and other resources that would be available to pay the price of a child’s meal.

The following form must be completed to apply for assistance. The completed application and required documentation of income supporting your child(ren) are necessary in order to make an eligibility determination. Incomplete applications will be returned.

Copies of documentation of income supporting your children can be made at the Business
Office at no charge to you if you submit your application in person. If mailed, documents will
not be copied and returned to you.

If you have any questions regarding the application process, please contact Allison Cafarella,
Financial Assistance Coordinator, at (508) 417-9381. Once a determination of eligibility has
been made, you will be notified of that decision by letter. Please allow two (2) weeks for


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