This education template includes 9 fields. Apply for a free or reduced-price school lunch program for qualifying students. Free to customize and use on ZenBuild.
Student Full Name (text, required)
Grade Level (text, required)
School Name (text, required)
Parent / Guardian Name (text, required)
Parent / Guardian Email (email, required)
Total Household Members (number, required)
Annual Household Income Range (dropdown selection, required) — options: Less than $20,000, $20,000 – $30,000, $30,001 – $40,000, $40,001 – $50,000, Above $50,000
Does the student receive SNAP or other federal assistance? (multiple choice, required) — options: Yes, No
Certification (checkboxes, required) — options: I certify that the information provided is true and accurate
