Title One Survey

Dear Parents and Guardians,
All schools of the Archdiocese of Philadelphia participate in several federal programs which provide our students with a variety of materials and services. It is one of the ways we receive benefits from your tax dollars, and your assistance is critical.
Please review the survey below. Your prompt response, which is confidental, is used only in reporting the number of students in Archdiocesan schools who are entitled to materials and services. This has no effect on financial assistance you receive through parish, school or private programs.

Please check any statement that applies to your family Eligible for Food Stamps Qualifies for Medicaid Qualifies for Home Energy Assistance (LIHEAP) Receives Supplemental Security Income Receives Housing Assistance (Section 8) Receives Temporary Assistance to Need Families (TANF)

If none of the above apply to your family, please exit now.

If you checked one or more of the above, please continue by answering the following questions and click Submit. All replies will be sent directly to Mrs. Judge's email.

Total number of people living in your household: REQUIRED

A household is all persons, including parents, children, grandparents and all people related or unrelated who live in your home and share living expenses.

Please fill out this field. Please enter valid data.

Public School District of Your Residence REQUIRED Please fill out this field. Please enter valid data.

Check off grade of each student in your household.

Check the box that most accurately reflects your TOTAL household income: REQUIRED Below $23,606 $23,607 - 31,894 $31,895 - $40,182 $40,183 - $48,470 $48,471 - $56,758 $56,759 - $65,046 $65,047 - $73,334 $73,335 - $81,622 Over $81,623 Please fill out this field.