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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