UCB CalFresh Student Screener
Thank you for your interest in CalFresh! Please fill out this screener prior to your appointment or CalFresh Clinic to determine if you are likely eligible for benefits.

Please note, you have the right to apply for CalFresh even if you don't appear to be eligible. 

For any questions, please visit https://basicneeds.berkeley.edu/calfresh or contact the BNC CalFresh Team by filling out this form: https://tinyurl.com/bncassistance 

Thank you!
Sign in to Google to save your progress. Learn more
Student ID: *
Student Name and Preferred Pronoun: *
Email *
County You Currently Live In *
Type of Appointment
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of UC Berkeley. Report Abuse