Cal-Fresh Food Aid Questionnair

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Is at least one person in your household a US Citizen or lawful permanent resident?*

Yes

No

Please select Yes or No

Are you enrolled in at least 6 units?*

Yes

No

Please select Yes or No

Do you have a state certified disability?

Yes

No

Please answer Yes or No

Are you working at least 20 hours per week?

Yes

No

Please answer Yes or No

Are you awarded or approved for work-study?

Yes

No

Please answer Yes or No

Are you in EOPS, CARE, or DSPS?

Yes

No

Please answer Yes or No

Do you have dependents under the age of 12?

Yes

No

Please answer Yes or No

Your household is likely not eligible for CalFresh Benefits.

Your household may be eligible for CalFresh. Please contact our office for more information on how to apply.