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Head of Household Signature Today s Date Email Address Printed Name FOR OFFICE USE ONLY Contact Number Total Household Members 1Weekly 1Bi-Weekly 1Monthly 1Bi-Monthly 1Annually Eligibility Determination Reason for Denial of Eligibility 1Categorical Eligibility 1Free 1Reduced 1Denied City Determining Official s Signature Date Confirming Official s Signature Date Verifying Official s Signature Date State Zip Code B. 2017-18 New Hanover County Schools Free and Reduced Price School Meals...
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