Lake Elsinore Unified School District Operation School Bell Application 1 Date & Time2 Participation Eligibility3 Income Verification4 Student Information5 Family Information Select your check in time* Community Mission of Hope H.O.P.E. Menifee Valley Community Cupboard Community Outreach of Murrieta Your student must be present for the Shopping Event and may be registered only one time. Participation Eligibility Before you proceed, you will need to confirm that, based on the income chart below, your Total Family Yearly Income from all sources qualifies you to participate in the shopping event. Participation Eligibility Confirmation*By checking the spaces below you are confirming that: Based on my Total Family Yearly Income my student(s) are eligible to participate. I understand that website registration is the ONLY way my student(s) can register for a shopping event. No phone or email registrations will be accepted.Register only once per student. Income Verification You will need to bring a COPY of your Total Family Yearly Income to the shopping event. Verifications that we will accept are listed below: Preferred is the previous Year Tax Return/1040. Previous Year W-2 for each family member contributing to the Total Family Yearly Income 3 most recent paycheck stubs for each family member contributing to the Total Family Yearly Income, Government Assistance such as: Passport to Services, Notice of Action, Cash Aid, SSI or Disability Letter from employer stating income amount Total Family Yearly Income Confirmation*Total Family Yearly Income documentation is required for all household members over the age of 18 who contribute to the Total Family Yearly Income.This information is confidential and is used to compile statistical data used for a federal grant which helps fund this program. Yes, I understand Student Information The following information is required for each student (Transitional K-12) Registered for a shopping event.Student Last Name*Enter the Student's informationStudent First Name*Enter the Student's informationGender*Make a selectionMaleFemaleOtherEnter the Student's informationDate of Birth* MM DD YYYY Enter the Student's informationAge*Please enter a number from 4 to 18.Enter the Student's informationGrade*Make a SelectionT-KindergartenKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeSelect Elementary School*Make a SelectionAlberhillCottonwood CanyonDonald GrahamEarl WarrenElsinoreLakeland Village SchoolLuiseno SchoolMachadoRailroad CanyonRice CanyonRonald ReaganTuscany HillsWildomarWilliam CollierWithrowLake Elsinore Unified School DistrictSelect Middle School*Make a SelectionCanyon LakeDavid A. BrownElsinore MiddleTerra CottaLake Elsinore Unified School DistrictSelect High School*Make a SelectionElsinore HighLakeside HighOrtega HighTemescal Canyon HighLake Elsinore Unified School DistrictStudent Street Address* Street Address City ZIP Code Enter the Student's informationEthnicity: (Select ONLY one from the Single-race or Multi-race categories) Single race category White Black/African American Asian American Indian/Alaskan Native Native Hawaiian/Other Pacific Islander Enter the Student's informationMulti-race Category American Indian/Alaskan Native & White Black/African American & White Hispanic/Black/African American Hispanic/American Indian/Alaskan Native Hispanic/Native Hawaiian/Other Pacific Islander Hispanic/American Indian/Alaskan Native & White American Indian/Alaskan Native & Black/African American Hispanic/American Indian/Alaskan Native & Black/African American Other Multi-race (ONLY if, non-of-the-above categories identifies you) Asian & White Hispanic/White Hispanic/Asian Hispanic/Asian & White Hispanic/Black/African American & White Enter the Student's information Family InformationParent/Guardian Last Name*Parent/Guardian First Name*Relationship to Student*Make a SelectionGuardianGrandfatherGrandmotherUncleAuntFatherMotherSisterBrotherCousinTotal Family Size*Female Head of Household* Yes No Parent/Guardian Email Address* Enter Email Confirm Email Phone Number*Do you have another student to register?* Yes No Unique ID
