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CCCApply

Supplemental Questions

AP-658 - Getting issue details... STATUS

Supplemental Questions

Consider including help text that can be shown while filling out the application. I didn’t see any for these supplemental questions.

Field Name

Field Type

Banner Integration

Standard Application 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)?

AFDC hasn’t been a program since 1997 when it was replaced by TANF. Should this even be a question anymore?

Radio buttons:

  • Yes

  • No (defaulted)

Are you receiving TANF/CalWORKs, SSI, or General Assistance?

tanf_ssi_ga

Yes [radio button]

No [radio button]

No selection

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

Does this need to be captured individually?

Radio buttons:

  • Yes

  • No (defaulted)

Are you receiving TANF/CalWORKs, SSI, or General Assistance?

tanf_ssi_ga

Yes [radio button]

No [radio button]

No selection

Are you a recipient of General Assistance or General Relief?

Does this need to be captured individually?

Does “General Relief” warrant an additional question or is it a synonym?

Radio buttons:

  • Yes

  • No (defaulted)

Are you receiving TANF/CalWORKs, SSI, or General Assistance?

tanf_ssi_ga

Yes [radio button]

No [radio button]

No selection

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

Radio buttons:

  • Yes

  • No (defaulted)

Are you otherwise economically disadvantaged?

Radio buttons:

  • Yes

  • No (defaulted)

Are you a single parent?

Radio buttons:

  • Yes

  • No (defaulted)

Are you a displaced homemaker?

Radio buttons:

  • Yes

  • No (defaulted)

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

Radio buttons:

  • Yes

  • No (defaulted)

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

What is this? Why do we ask this?

Radio buttons:

  • Yes

  • No (defaulted)

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

Radio buttons:

  • Yes

  • No (defaulted)

Are you an ex-offender?

Radio buttons:

  • Yes

  • No

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?

Radio buttons:

  • Yes

  • No (defaulted)

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?

Radio buttons:

  • Yes

  • No (defaulted)

Emergency Contact (required)

Question

Field Name

Field Type

Banner Integration

First Name

Text box

Unvalidated; user can enter blatantly false data.

Required field

Last Name

Text box

Unvalidated; user can enter blatantly false data.

Required field

Area Code

Text box

Unvalidated; user can enter blatantly false data.

Required field

Phone

Text box

Unvalidated; user can enter blatantly false data.

Required field

Extension

Text box

Unvalidated; user can enter blatantly false data.

Required field

Address Line 1

Text box

Unvalidated; user can enter blatantly false data.

Required field

Address Line 2

Text box

Unvalidated; user can enter blatantly false data.

Required field

City

Text box

Unvalidated; user can enter blatantly false data.

Required field

Zip

Text box

Unvalidated; user can enter blatantly false data.

Required field

Their relationship to you:

Dropdown:

  • Mother

  • Father

  • Spuse

  • Brother

  • Sister

  • Ex-spouse

  • Grandparent

  • Relative

  • Guardian

  • Domestic Partner

  • Significant Other

  • Child

  • Doctor

  • Employer

  • Neighbor

  • Friend

State

Dropdown

States (and Territories, Armed Forces)

Countries

Dropdown

Current Math Class

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?

Dropdown

  • Pre-algebra or lower

  • Algebra 1

  • Integrated Math 1

  • Integrated Math 2

  • Geometry

  • Algebra 2

  • Integrated Math 3

  • Statistics

  • Integrated Math 4

  • Trigonometry

  • Pre-Calculas

  • Calculus or higher

  • None of the Above

  • I am not currently taking a math class

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

https://sequoias.atlassian.net/browse/AP-652

Are you interested in resources for undocumented students?

Yes/No Radio Boxes

https://sequoias.atlassian.net/browse/AP-653

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

Yes/No Radio Boxes

https://sequoias.atlassian.net/browse/AP-654

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

https://sequoias.atlassian.net/browse/AP-655

Are you a single Parent?

vt1

Yes/No Radio Boxes

https://sequoias.atlassian.net/browse/AP-656

Are you a displaced homemaker?

vt2

Yes/No Radio Boxes

https://sequoias.atlassian.net/browse/AP-657

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