[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-203434-105":3,"detail-sidebar-cat-0-en-105":85,"doc-detail-203434-en":134},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":78,"head_meta":80,"extra_data":82,"updated_unix":84},105,"en","supplemental-consent-form","Supplemental Consent Form","","This document outlines a supplemental consent form for parents and guardians regarding the sharing of student meal eligibility status for participation in other school programs. Students qualifying for free or reduced-price meals may be eligible for fee waivers or reductions for extracurricular activities, academic fees, and scholarships. The form is optional and requires a signature to grant permission for sharing this information. It details how the shared information will be used and provides a section to list all students attending school that the guardian wishes to be considered for these benefits. The form also includes fields for parent/guardian contact information and a signature, along with instructions for submission to the school office or food service department. The institution affirms its commitment as an equal opportunity provider.",{"@graph":14,"@context":77},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/supplemental-consent-form/203434/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/supplemental-consent-form/203434.png","ImageObject",300,407,{"name":42,"@type":43},"Stanley","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-07","2026-09-04",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69,73],{"name":60,"@type":61,"acceptedAnswer":62},"What is the purpose of this supplemental consent form?","Question",{"text":63,"@type":64},"The form allows parents to grant permission for their student's free or reduced-price meal eligibility status to be shared with school administrators for potential benefits in other school programs, such as fee waivers for extracurricular activities or academic programs.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Is it mandatory to fill out this form?",{"text":68,"@type":64},"No, this form is optional. Submitting it will not affect a student's eligibility for free or reduced-price meals. However, signing it is required to allow the sharing of eligibility status for other program benefits.",{"name":70,"@type":61,"acceptedAnswer":71},"What specific school programs can students benefit from through this form?",{"text":72,"@type":64},"Students may become eligible for fee waivers or reductions for extracurricular activities (like ASB fees, sports participation, event tickets, field trips), academic/curricular fees, building scholarships, and gap closing initiatives aimed at supporting student achievement.",{"name":74,"@type":61,"acceptedAnswer":75},"Who will have access to the shared student information?",{"text":76,"@type":64},"The shared information will be accessible only to the designated administrator or bookkeeper for the child's school, solely for the purpose of establishing eligibility and providing benefits for the selected programs.","https://schema.org",{"og:url":32,"og:type":79,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":81,"canonical":32},"index,follow",{"doc_id":83,"site_id":7},203434,1788560794,{"code":4,"msg":86,"data":87},"success",[88,92,96,100,105,110,113,118,123,126,130],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},"Exam",70,"exam",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},5,"Comic",60,"comic",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":107,"show_sort_weight":108,"slug":109},6,"Technology",50,"technology",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":111,"slug":112},40,"healthcare",{"id":114,"doc_module":4,"doc_module_name":25,"category_name":115,"show_sort_weight":116,"slug":117},8,"Research & Report",30,"research-report",{"id":119,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":121,"slug":122},9,"Religion & Spirituality",20,"religion-spirituality",{"id":121,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":121,"slug":125},"World Cup","world-cup",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":127,"slug":129},10,"Lifestyle","lifestyle",{"id":131,"doc_module":4,"doc_module_name":25,"category_name":132,"show_sort_weight":101,"slug":133},19,"General","general",{"code":4,"msg":86,"data":135},{"doc_id":83,"user_id":136,"nickname":42,"user_avatar":137,"doc_module":4,"category_id":55,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":143,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":12,"update_tm":84,"read_time":30},2336477405376,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Students that qualify for free or reduced meals, may be eligible for free or reduced fees to participate in other school programs.  \nThis form is optional, submission of this form will not affect your student’s eligibility for free or reduced-price meals. You must sign the form to allow your eligibility status to be shared for these other program benefits:  \n\n| Check to\u003Cbr>participate | Title of school program | How the shared information will be used |\n| --- | --- | --- |\n| | Extracurricular activities-Associated Student Body (ASB) fees, Sports Participation fees, Event Tickets, Fieldtrips | Eligibility for fee waiver |\n| | Local Aid – Academic/Curricular Fees, Building Scholarships | Eligibility for fee waiver or reduction |\n| | Criterion 8 – Closing the Achievement Gap | For the purpose of gap closing and supporting student’s achievement |\n\nList ALL students living with you that are attending school and that you would like to be considered for the listed benefits based on their free and reduced‐price meal eligibility status:  \n\n| Student’s Full Name | Student’s School |\n| --- | --- |\n|  |  |\n|  |  |\n|  |  |\n|  |  |\n|  |  |\n|  |  |\n|  |  |\n\nBy signing below, you grant permission for your student’s meal eligibility to be shared with only the designated administrator or bookkeeper for the child’s school, solely for establishing eligibility and providing benefits of the selected programs above.  \nPrinted Name:    \nSignature of Parent/Guardian:   Date:   \nE‐Mail Address:   Phone:    \n(Complete, sign, and return to Your School Office, or mail to ISD Food Service, 16430 SE May Valley Rd, Renton, WA 98059)  \nSchool District Personnel: This form MUST be returned to the Food Service office via interdistrict mail or emailed to GarciaA@issaquah.wednet.edu or [Lisserb@issaquah.wednet.edu](Lisserb@issaquah.wednet.edu)  \nThis institution is an equal opportunity provider.","cbCaim5cWH5zsPUr","https://ap.wps.com/l/cbCaim5cWH5zsPUr","pdf",147711,"English","# Supplemental Consent Form\n## Student Benefits Based on Meal Eligibility\n## Student Information\n## Parent/Guardian Consent and Contact Information","[{\"question\":\"What is the purpose of this supplemental consent form?\",\"answer\":\"The form allows parents to grant permission for their student's free or reduced-price meal eligibility status to be shared with school administrators for potential benefits in other school programs, such as fee waivers for extracurricular activities or academic programs.\"},{\"question\":\"Is it mandatory to fill out this form?\",\"answer\":\"No, this form is optional. Submitting it will not affect a student's eligibility for free or reduced-price meals. However, signing it is required to allow the sharing of eligibility status for other program benefits.\"},{\"question\":\"What specific school programs can students benefit from through this form?\",\"answer\":\"Students may become eligible for fee waivers or reductions for extracurricular activities (like ASB fees, sports participation, event tickets, field trips), academic/curricular fees, building scholarships, and gap closing initiatives aimed at supporting student achievement.\"},{\"question\":\"Who will have access to the shared student information?\",\"answer\":\"The shared information will be accessible only to the designated administrator or bookkeeper for the child's school, solely for the purpose of establishing eligibility and providing benefits for the selected programs.\"}]","Supplemental Consent Form | PDF"]