Income Survey Form

Complete the 2023-2024 Income Survey Form

Visit www.schoolcafe.com/springbranchisd to complete this form for your child's school.

Important: Families should complete this form after July 1st, each school year. Please contact your child’s campus as soon as possible if you have any questions about this important form

Non-discrimination Statement: This explains what to do if you believe you have been treated unfairly.

Non-discrimination Statement: This explains what to do if you believe you have been treated unfairly.

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;

(2) fax:

(202) 690-7442; or

(3) email:

program.intake@usda.gov.

This institution is an equal opportunity provider

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Income Survey Form

Complete the 2023-2024 Income Survey Form

Non-discrimination Statement: This explains what to do if you believe you have been treated unfairly.

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