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CalFresh Enrollment Party
Hello everyone!
Thank you for taking an interest in applying to Calfresh with a Basic Needs Advocate!
Please fill out this form so that your Basic Needs Advocate can know more about your situation and better assist you in your CalFresh application. The virtual enrollment party is on 1/13/2021 at 6pm.
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* Indicates required question
Email
*
Your email
Full Name
*
Your answer
What is your preferred method of contact? (choose as many as you like)
*
Text
Email
Phone Call
Other:
Required
Pronouns
*
Your answer
Phone Number
*
Your answer
7 digit perm number
*
Your answer
Date of Application
MM
/
DD
/
YYYY
Class Level
*
Undergrad
Grad
Post-doc
Are you 18 years or older & are you a US Citizen or permanent resident?
*
Yes
No
Year in School (first year transfer students are considered third years)
*
First
Second
Third
Fourth
Fifth
Other:
Where are you currently residing?
*
I am outside of Santa Barbara County and living with my guardians
I am in Isla Vista living outside of my guardians
I am in somewhere else in Santa Barbara County outside of my guardian's residence
I am outside of Santa Barbara County living outside of my guardian's residence
Required
Street Address (use the same address as your Calfresh application)
*
Your answer
County (most likely Santa Barbara County)
*
Your answer
Can we text, email, or call you regarding your CalFresh case and identify ourselves as CalFresh Advocates?
*
Yes
No
How did you hear about us?
*
Your answer
Are you displaced?
*
Yes, I am sleeping in a car, sleeping at a shelter, houseless, couch surfing, or with uncertain housing
No, I have housing security
Birthdate
*
MM
/
DD
/
YYYY
Age
*
Your answer
Check all that apply:
*
College student
Working low-income (do you have a job?)
Children under 18
Receiving SSI
Language Access Barrier
Military / Veteran
None of these apply
Required
Student Exemption Information (check all that apply):
*
Applicant usually works over 20 hours a week
Applicant is approved for Work Study
Applicant receives Cal Grant A or B
Applicant is enrolled in a qualified employment, training, or foster program (EOP, EOPS, TEP, CARE, UC McNair, Puente Project, MESA, DSP, etc.)
Applicant is enrolled in a program that increases employability for current or former foster youth (Guardian Scholars, CalWORKS, JOBS)
Applicant has a dependent under 12 years old
Applicant does not plan to be enrolled next term
None of these apply
I'm not sure
Required
Would you like to receive monthly email updates about other Basic Needs resources on campus?
*
Yes
No
Thank you!
Visit our website to learn more about basic needs at UCSB!
https://food.ucsb.edu/
Look forward to helping you apply!
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