Request CalFresh Assistance

CalFresh is a food assistance program that provides money to buy groceries each month. After completing this form, a CalFresh Specialist from Feeding San Diego will call you in 1-2 days to help you apply for CalFresh. Questions? Call/Text our CalFresh Line: 858-863-6635 Please note: This form is NOT a CalFresh application. If you need immediate assistance, please call 211.

Last Name

First Name

Phone Number

Email (Optional)

What language do you prefer?

We offer assistance in English and Spanish. If you prefer another language, we will try to connect you with an organization that can provide assistance in that language.

English

Español

Other/Otro

How can we help you?

Please select all that apply.

I have a general CalFresh question. (Tengo una pregunta en general sobre CalFresh.)

I would like to know if I'm eligible for CalFresh. (Me gustaría saber si soy elegible para CalFresh.)

I would like to submit a new CalFresh application. (Me gustaría mandar una nueva aplicasion.)

I need help with my SAR-7 -- 6 month renewal. (Necesito ayuda con mi SAR-7).

I need help with my annual recertification. (Necesito ayuda con mi reporte anual.)

I have a question or issue with an existing CalFresh case. (Tengo una pregunta o necesito ayuda con un caso existente de Calfresh.)

Other (Otro)

Household Size

Total number of people in household who live and buy/prepare food together.

Monthly Income

Gross monthly income for all household members. This includes earned income from a job and unearned income from SSI, Social Security, pension, unemployment benefits, etc.

Please select all that apply to you:

This information helps us determine your eligibility for CalFresh.

College Student (Va al Colegio)

Have children 0-18 (Tiene niños de 0-18 años)

SSI recipient (Recibe SSI -- Seguro Social Suplemental)

Working (Está trabajando)

Senior, over 60 years (Persona mayor de 60 años o más)

Unemployed (Desempleados)

None of the above (Ninguno de los mencionados anteriores)

Prefer not to share (Prefiere no compartir)

What are the best days to contact you?

Please select all the days that work for you.

Send me a copy of my responses

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