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CCCApply Supplemental Questions

Question

Field Name

Field Type

Banner Integration

Are you a recipient of CalWORKs, Temporary Assistance for Needy Families (TANF), or Aid to Families with Dependent Children (AFDC)?

Note

CalWORKs, TANF are asked as part of Standard Application>tanf_ssi_ga. AFDC hasn’t been a program since 1997 when it was replaced by TANF. Should this even be a question anymore?

Are you a recipient of CalWORKs, Temporary Assistance for Needy Families (TANF), or Aid to Families with Dependent Children (AFDC)?

Note

CalWORKs, TANF are asked as part of Standard Application>tanf_ssi_ga. AFDC hasn’t been a program since 1997 when it was replaced by TANF. Should this even be a question anymore?

Are you a recipient of Supplemental Security Income (SSI)?

Note

Asked as part of Standard Application>tanf_ssi_ga.

Are you a recipient of General Assistance or General Relief?

Note

“General Assistance” asked as part of Standard Application>tanf_ssi_ga. Does “General Relief” warrant an additional question or is it a synonym?

Are you a recipient of Cal Fresh, food stamps, or the Supplemental Nutrition Assistance Program (SNAP)?

Are you otherwise economically disadvantaged?

Are you a single parent?

Are you a displaced homemaker?

Have you, your parent, or guardian been employed as a migrant farmworker at any time in the past 36 months?

Do you possess attitudes, beliefs, customs, or practices that serve as a hindrance to employment?

Note

What is this? Why do we ask this?

If you are unemployed, have you been looking for work for 27 weeks or more?

Are you an ex-offender?

Are you or your parent/guardian employed on U.S. National Forest property within Tulare County: or, working in U.S. National Forest Service Facilities outside the National Forest but still within Tulare County boundaries?

Do you reside on U.S. National Forest land; or property leased from the U.S. Forest Service; or privately owned land (enclosed within the boundaries of the U.S. National Forest within Tulare County); or privately owned land within one mile of the boundaries of the U.S. National Forest?

...

Emergency Contact (required)

Question

Field Name

Field Type

Banner Integration

First Name

Last Name

Area Code

Phone

Extension

Address Line 1

Address Line 2

City

Zip

Their relationship to you:

State

Country

The following question will help us place you in the most appropriate Math class.

Question

Field Name

Field Type

Banner Integration

If you are taking a math class currently, which class is it?

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Pre-Registration Survey

...

Question

Field Name

Field Type

Banner Integration

My Campus:

Select the campus that you will attend most/all of your classes:

Dropdown:

Visalia Campus

Hanford Campus

Tulare Campus

Are you interested in resources for undocumented students?

Yes/No Radio Boxes

Are you interested in receiving information about housing and/or homeless resources?

Yes/No Radio Boxes

Choose which apply from the list below:

opt1

opt2

opt3

opt4

opt5

CalWORKs/TANF/AFDC recipient

SSI recipient

General Assistance recipient

Other economically disadvantaged status

None of the above

Are you a single Parent?

vt1

Yes/No Radio Boxes

Are you a displaced homemaker?

vt2

Yes/No Radio Boxes

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