CARE Eligibility Requirements
(Additional benefits for a single parent receiving public assistance)
I am a single parent/ head of household. Yes No
I am receiving Cal-Works benefits. Yes No
I have dependent child(ren) under 14 years of age. Yes No
OFFICE USE ONLY:
Writing______ Math______
FAFSA EFC
Cum. GPA CA Promise
Transcripts Missing: Yes No
Unit waiver Cum. Units
Male Female Non-Binary Other
Ethnicity CARE
Approved Denied Pending
Application
Semester: Fall Spring
Step 1: Contact Information
LAST NAME: FIRST NAME M.I. EVC I.D.#
ADDRESS: APT.# CITY: ZIP CODE:
TELEPHONE: DATE OF BIRTH: EMAIL:
ETHNIC BACKGROUND: PRIMARY LANGUAGE SPOKEN AT HOME:
Step 2: Eligibility Requirements
Step 3: Educational History
List previously attended educational institutions and submit unofficial college transcripts with this application.
High School Attended to
Year Year
Other School Attended to
(College(s)) Year Year
Step 4: Educational Goal
Associate degree
Transfer to CSU
Transfer to UC
Vocational Certificate/License
Intended Major
Are you a California Resident?
Yes
No
Did you enroll in 12 units or more? (exemption for students with a verified disability)
Yes
No
Have you applied for a California Promise Grant?
Yes
No
Do you have a high school diploma or GED?
Yes
No
Did you graduate from high school with a less than 2.5 GPA?
Yes
No
Are you an emancipated foster youth?
Yes
No
Did either of your parents graduate from a 4-year US College (BA/BS)?
Yes
No
Has the Admissions or Registrar's Office determined that you are exempt from paying nonresident tuition
under education Code Section 68130.5 (AB 540)?
Yes
No
I hereby certify that the information provided on this application is accurate and complete to the best of my knowledge.
Signature Date
Extended Opportunity Programs & Services / Cooperative Agencies Resources for Education
click to sign
signature
click to edit
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