Noncredit Basic Needs Assistance Application

This process will connect you with the Basic Needs Expert/Counselor. The Basic Needs Expert/Counselor can help by identifying and connecting you to resources such as emergency aid, affordable food, housing, school supplies, technology, transportation, childcare, mental health care, and personal care items.


  • This form is to request housing navigation support, CalFresh assistance, Basic Needs Cards, and if available, emergency financial grant funds.
  • This form schedules you with a Basic Needs Expert/Counselor.
  • Submitting this application does not automatically guarantee all services applied for.
  • This tool is used to assess eligibility and to gather information prior to the student meeting with the Basic Needs Resources Expert/Counselor.
  • Most services are currently only available for enrolled students.


Upon completion of this form, you will receive an email containing the booking link to schedule your appointment with the Basic Needs Resources Counselor. You will be able to select one of the following meeting methods: in-person, phone, or zoom. Once you have scheduled your appointment, you will receive a calendar invite via email with meeting instructions. Please note for in-person meetings, your meeting will be held in Building 30 (Adult Basic Education).

A lived name is a self-chosen or personal and/or preferred name used instead of a legal name (only need to include if it's different than the "First Name" you listed above)

Phone

For Questions 7-9, if you are experiencing homelessness, please indicate the City, State, and Postal Code you most reside in.

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If your gender identity is not listed, please write it into the box.

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