SNAP Assistance Request Form
Thanks for connecting with the Student Parents At Manoa (SPAM) program. You DO NOT need to have children to apply for SNAP. Please fill out the following form.  We will contact you via email from with information about your eligibility and how to apply for the Supplemental Nutrition Assistance Program (SNAP).  

F1-Visa students are Not eligible for SNAP. However, F1-visa student WITH children who are US citizens may have children whom are eligible. Email:

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Email *
Full Birth Name *
May we contact you through E-mail? *
Are you a Student? *
Please select the option that Describes You: *
What is your Age? *
If you are age 21 or younger, Do you live with your parent(s)?
Clear selection
Do you have Dependents? *
Are you married? *
If you have Children, please list their ages.
Do you have a Federal Work-Study award? *
Are you currently working a Federal Work-Study job? *
Are you currently Employed? (paid for service) *
How many hours do you work weekly? (Please type none if not currently employed) *
What is your per-hourly rate of pay? (Please type none if not currently employed) *
How many people are in your household (people who you purchase & prepare food with & share expenses) including yourself? *
What is the combined monthly gross income (before taxes) of your household (number of people who purchase & prepare food with you)? Please include all sources of income, including social security, child support, SSI, VA benefits, etc., (do NOT include scholarships/financial aid).
Clear selection
What monthly expenses do you have? (select all that apply)
List the total amount you pay for each expense selected above. (Approximate amount)
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