If you are human, leave this field blank.Subsidy Application FormChild 1 - Legal Last Name:Child 1- Legal First Name:School:---Connaught Heights ElementaryÉcole Qayqayt Elementary SchoolF.W. Howay Elementary SchoolÉcole Herbert Spencer Elementary SchoolLord Kelvin Elementary SchoolÉcole Lord Tweedsmuir Elementary SchoolQueen Elizabeth Elementary SchoolSkwo:wech Elementary SchoolÉcole Glenbrook Middle SchoolQueensborough Middle SchoolFraser River Middle SchoolGrade---KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8DivisionChild 2 - Legal Last Name:Child 2 - Legal First Name:School:---Connaught Heights Elementary SchoolÉcole Qayqayt Elementary SchoolF.W. Howay Elementary SchoolÉcole Herbert Spencer Elementary SchoolLord Kelvin Elementary SchoolÉcole Lord Tweedsmuir Elementary SchoolQueen Elizabeth Elementary SchoolSkwo:wech Elementary SchoolÉcole Glenbrook Middle SchoolQueensborough Middle SchoolFraser River Middle SchoolGrade---KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8DivisionChild 3 - Legal Last Name:Child 3 - Legal First Name:School:---Connaught Heights Elementary SchoolÉcole Qayqayt Elementary SchoolF.W. Howay Elementary SchoolÉcole Herbert Spencer Elementary SchoolLord Kelvin Elementary SchoolÉcole Lord Tweedsmuir Elementary SchoolQueen Elizabeth Elementary SchoolSkwo:wech Elementary SchoolÉcole Glenbrook Middle SchoolQueensborough Middle SchoolFraser River Middle SchoolGrade---KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8DivisionChild 4 - Legal Last Name:Child 4 - Legal First Name:School:---Connaught Heights Elementary SchoolÉcole Qayqayt Elementary SchoolF.W. Howay Elementary SchoolÉcole Herbert Spencer Elementary SchoolLord Kelvin Elementary SchoolÉcole Lord Tweedsmuir Elementary SchoolQueen Elizabeth Elementary SchoolSkwo:wech Elementary SchoolÉcole Glenbrook Middle SchoolQueensborough Middle SchoolFraser River Middle SchoolGrade---KindergartenGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8DivisionParent/Legal Guardian Full Name: *Contact Email:Please give the email address that the Fuel Up Coordinator should contact to confirm arrangements.Telephone:I am seeking a lunch subsidy for:To help us understand the needs families are facing, or to anticipate what that looks like over time, we'd appreciate if you can take a moment to share this information with us. If you don't feel comfortable, we understand and you can skip this question. If comfortable, please briefly describe your reasons for applying for the Fuel Up! subsidy:To assist in providing as many healthy meals as possible, we ask that families please pay what they can. Some families will require a full subsidy, where meals will be provided at no cost to the families, and some families will be able to pay a partial fee, supplemented with a partial subsidy. Subsidies can only be used toward the purchase of one hot or cold entrée per school day (small size for $5.75 or larger sizes for $6.75). Do you require a partial subsidy or a full subsidy? Subsidy Level:I require a PARTIAL subsidy and am able to pay $2.75 toward a daily hot or cold entrée itemI require a PARTIAL subsidy and am able to pay $1.00 toward a daily hot or cold entrée itemI require a FULL subsidyI have read and understand (please select all): *the program informationevery effort will be made to provide allergen free meals, however, common food allergens are used in our caterer's kitchen and cross contamination is always a possibility.that if my child(ren) has severe allergies, I should pack a meal from home instead of using the school lunch program.If approved:If your application to receive either partial or full subsidy is approved, the approval will be given for the full school year. If family circumstances change and you no longer wish to partake in the program, you can contact the team at Simply Foods or your school Principal to adjust the financial approval listed in the system. Submit
