EOPS Programs Intake Application

You are now completing an application to be considered for the EOPS, CARE & Next Up programs. Once this form is submitted, you will be contacted to schedule an intake appointment where your application will be reviewed and confirmed for admission to the support programs you are eligible for. For your application to be considered, applicants must;


  • have submitted a Foothill College admissions application through OpenCCC for the current or upcoming term.


  • have completed a financial aid application (FAFSA, CA Dream Act or California College Promise Grant) for the current academic year.


  • be prepared for the appointment with unofficial transcripts if you are transferring from another college (DeAnza transcripts not required).
Phone

check all that apply

Educational Background*

The high school where you received a diploma

City and State

Have you attended college(s) previously?*

If you have earned more than 105 quarter units (or 70 semester units) or have earned a bachelor's degree, you will not be eligible for EOPS.

Please attach transcript by using the File Upload at the end of the form (unofficial transcript accepted)

Leave it blank if no additional college attended

Please attach transcript (unofficial transcript accepted)

Please attach transcript (unofficial transcript accepted)

Educational Goal*
EOPS Status*

The name of the college where you were enrolled in EOPS

When did you enroll in the college's EOPS program?

Enrollment Status*
Are currently or formally a foster youth?*
Select or enter value
Caret IconCaret symbol
Were you enrolled in foster care on or after your 13th birthday?*
Will you be under the age of 26 as of July 1 of the current year?*
CARE (Cooperative Agencies Resources for Education*

Are you a single parent?

Do you receive Temporary Aid to Needy Family?

Are you at least 18 years of age?
Are you a single, head of household?
Are you part of the CalWorks program?
Marital Status

Leave blank if no additional child

I have read the Terms of Agreement and the Mutual Responsibility Contract, https://foothill.edu/eops/MRC_Placeholder.pdf , to the best of my knowledge, the information I have provided is accurate and is truthful. In lieu of my written signature, by submitting this application electronically, I authorize the EOPS program at Foothill College to evaluate and determine my eligibility to participate in the program.

Any information provided on this Intake Application that is found to be untruthful or in error and cannot be corrected within a timely manner will not be considered. If any information provided on this form is submitted in error, please notify the EOPS representative when you are contacted. Additional Documentation may be required.

(EOPS Office Only)

Please upload any other college transcript(s) here, unofficial ones are accepted.

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