Family Income Survey

We encourage you to complete the form as your children may be eligible for free and reduced meals, reduced vendor rates, athletic fees, and after-school program fees.

Completing this form is also helpful for charter schools and districts as this information will affect grant funding eligibility, how the charter school is represented in the media and the charter school’s comparison to other similar schools in the annual report card.

  • Do I need to fill out a survey for each child?  No. Use one survey for all students in your household. We cannot approve an application that is not complete so be sure to fill out all required information. Return the completed application by email to April Tubbs at  or mail to TEACH-NW, ATTN: April Tubbs, P.O. Box 70365, Springfield, OR 97475

  • My family needs more help.  Are there other programs we might apply for?  To find out how to apply for other assistance benefits, contact your local assistance office or call 2-1-1- or 1-800-SAFENET (723-3638). For food assistance call 1-866-348-6479 (1-866-3-HUNGRY).  In the summertime, Text “FOOD” to 877877 or visit  for free summer meal options in your area.

If you have other questions or need additional assistance, contact April Tubbs via email at