2021-2022 Household Economic Survey
2021-2022 HEC
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Greetings, USD 114 - Riverside Families:
Thank you for your continued support of our students, staff, and school community. We hope you are well, and we are reaching out today with some important information and a process that can assist families and our school district. Even though all children will eat free during the 2021-22 school year, the Household Economic Survey (HES) generates additional funding for our local educational programs.

We encourage all families to consider, review, and complete the HES application. Eligibility determination will be made according to the established guidelines, and if your family qualifies the district will receive the funds accordingly. A few additional reasons for this consideration include:

● There are other school district benefits for families that qualify, such as Backpack Buddies, Dental Screening, HCC Technical Center
● If families do not complete the application, State funding for our school district may be reduced.

Below is the HES application for your convenience and consideration. Please feel free to contact our district’s office with any questions using the information below.

Terri Heater, theater@cyclones114.org
PO Box 368
Elwood, KS 66024
913.365.6735

If you prefer, you can submit the Household Economic Survey application by mail or return it in person at your child’s school by requesting a copy at the school or submitting your email to have one sent to you. If you decide to send your documents by mail, please send them to the address above. Thank you for your consideration in this critical process.

Sincerely,

John Whetzal
Superintendent of Schools  
USD 114 - Riverside

This form is required for your school to receive specific state and federal benefits and funding.
There are ____ people in my household, including all children and adults. *
The total annual income for all people in the household before any deductions for taxes, insurance, medical expenses, child support, etc. is ________ per year. *
Certification
I certify that all information on this application is true and that all income is reported. I understand that the school will receive federal and state funding based on the information provided. I understand that school officials may verify the information.  I certify by typing my name below:
Signature: Please type your name here *
Date *
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Phone *
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