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Elem. Economically Disadvantaged Application P. 19/19

Wilson Public School

School Year: 2020/2021

Economically Disadvantaged Application

This application should be completed even if your student attends a Community Eligibility Provision or Provision School


Please select the income range that represents the total gross income of your household:
Answer Required
Please select the total number of people in your household*
Answer Required

Signature: I certify that all information provided on this form is true to the best of my knowledge and that all household income is reported.  I understand that this information will impact federal and state funding to the school.

For office use only:



Not Qualified

Clicking on submit is the same as signing this form