SBAS Personal Status Form
In order to make sure that we are providing you with the maximum amount of support in your learning at the South Bay Adult School, we need you to answer the questions in this short questionnaire. Your answers are completely confidential. If you like, you can click on the translation tool in the browser.
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Email *
First Name *
Last Name *
Date of Birth *
Current Classes (check all that apply) *
Instructor(s) *
Dislocated Worker Program *
The Adult and Dislocated Worker Program, under Title I of the Workforce Investment Act of 1998, is designed to provide quality employment and training services to assist eligible individuals in finding and qualifying for meaningful employment, and to help employers find the skilled workers they need to compete and succeed in business.
U.S. Veteran(Previously served in the US military) *
Have you ever been a member of the military of the United States of America. This includes the Army, Navy, Air Force, Marines, Coast Guard and Space Force.
CalWORKs is a welfare program that gives cash aid and services to eligible needy California families. The program serves all 58 counties in the state and is operated locally by county welfare departments. If a family has little or no cash and needs housing, food, utilities, clothing or medical care, it may be eligible to receive immediate short-term help. Families that apply and qualify for ongoing assistance receive money each month to help pay for housing, food and other necessary expenses.
Cal Fresh/Food Stamps/SNAP *
The Supplemental Nutrition Assistance Program (SNAP) is the largest federal nutrition assistance program. SNAP provides benefits to eligible low-income individuals and families via an Electronic Benefits Transfer card. This card can be used like a debit card to purchase eligible food in authorized retail food stores.
General Relief  (GR) *
General Relief (GR) is a County-funded program that provides cash aid if you are an adult without any income or resources, and children in certain special circumstances who are ineligible for federal or State programs.
Refugee Cash Assistance *
RCA is a cash assistance program for refugees without children who are not otherwise eligible for any other cash aid.  RCA also includes employment and other social services to assist a refugee in becoming self-sufficient.
Supplemental Security Income (SSI) is a Federal income supplement program funded by general tax revenues (not Social Security taxes). It is designed to help aged, blind, and disabled people, who have little or no income; and it provides cash to meet basic needs for food, clothing, and shelter.
Other Public Assistance *
What big goals do you have at SBAS? *
What other goals do you have at SBAS? *
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