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Emergency Notification

CalFresh Student Pre-Screening Form

This pre-screening form will give our staff insight into your eligibility to apply for CalFresh benefits. Once we receive the completed form, we will contact you to assist you with next steps. Please do not worry if there are questions you do not understand or cannot answer - a CalFresh Outreach staff member will go over everything with you.

Before you begin, please consider the following:

  • Visit our website to review eligibility requirements under the "Am I Eligible?" tab.

  • Students who live with their parents must be 22 years of age or older to apply as an individual household.

  • This is a federally funded program, applicants must have U.S. citizenship or Lawful Permanent Resident status to qualify. 

If you would like to ask us a question before submitting a form, please e-mail us at [email protected].

If you are a part of a "Mandatory Household" (see checkbox options), then you must apply together with the other adult members of your household (Cal State LA CalFresh staff can help with that).
The amount of CalFresh benefits one is eligible for is determined in part by the size on one's household. Household = an individual, couple, or family that purchases and prepares food together
SEE previous question for number of people in your household.
Remember this applies to you if you are a household of one.
If yes, household members with a secured food source will not be eligible for CalFresh food benefits.