Brown University Division of Pre-College and Undergraduate Programs | Box 1851 | Providence, RI 02912 | 401-863-7900
FREE OR REDUCED LUNCH
VERIFICATION FORM
Dear Student,
In order for us to approve your request for an application fee waiver based on your eligibility for
need-based free or reduced school lunch, please have a sta member from your school complete
this form or give you a typed letter stating your school oers need-based free lunch to all students
or that you personally qualify for free or reduced lunch for another need-based reason. We
suggest reaching out to one of the following individuals for the letter:
• Guidance counselor
• School secretary or other administrative sta member
• Vice-principal
One of these individuals should be able to complete this form, or give you a typed letter on school
letterhead with their contact information, stating that your school oers need-based school-wide
free lunch or that you personally qualify or would qualify for free or reduced lunch for another
need-based reason. Once your school has completed this form, or you have received a typed
letter, you should upload it in your application when prompted.
To be completed by school sta member:
• I hereby certify that (student name) receives free lunch
as part of our school’s participation in the school-wide free lunch program through the
Community Eligibility Provision (CEP*). (Universal free lunch programs do not qualify,
unless the student would otherwise qualify for another need-based reason.) -or-
• I hereby certify that (student name) receives need-based free
or reduced school lunch, or would qualify for another need-based reason.
Name of School:
School Sta Member Name:
School Sta Member Title:
School Sta Member Contact Email/Phone:
*CEP is The Community Eligibility Provision (CEP) is a non-pricing meal service option for schools and
school districts in low-income areas. Visit https://www.fns.usda.gov/school-meals/community-eligibility-
provision for more information.
