CARE Certification Form 2023-2024

CARE regulations require coordination of applicable educational support services and welfare-to-work activities and verification of financial resources. The information provided will be used only to determine CARE program eligibility and will be kept confidential pursuant to Sections 76200-76246 of the California Education Code and the 1974 Family Educational Rights and Privacy Act.

To apply for the CARE program, proof of county cash aid assistance (Verification of Benefits) IS REQUIRED. 

 The 2023-2024 CARE Agency Certification form allows the CARE program to verify CalWORKs/TANF/Tribal TANF eligibility with the Department of Public Social Services on your behalf. 

If you need assistance, email careinfo@elcamino.edu. CARE Staff will contact you within 2 to 3 business days.  

Program Overview: The Cooperative Agencies Resources for Education (CARE) program was established in 1982 by the State of California as a supplemental component of EOPS to provide educational support services and activities for the academically underprepared, welfare-dependent, single head of household student population. CARE specifically serves EOPS students who, at the time of acceptance into the program, are 18 years old and single heads of household, current recipients of assistance from CalWORKs/TANF/Tribal TANF (California Work Opportunity and Responsibility to Kids/Temporary Assistance for Needy Families) for themselves or their dependents and are enrolled as full-time community college students (some exceptions to full-time enrollment exist).

Name*
Are you, or your dependents, currently receiving TANF or CalWORKs (eligibility requirement)?*
Are you considered Single Head of Household by the Department of Public Social Services?*
Current Marital Status *
Date TANF/CalWORKs benefit began*



CARE program participants must provide proof that you are receiving CalWORKs Cash Aid benefits by submitting a copy of your Verification of Benefits (VOB). This information can be located on your BenefitsCal account--> Your Application and Cases--> View Case Details--> Scroll to the bottom of the page-->Under Verification of Benefits, click "Download Your Verification of Benefits." Click here for additional instructions on how to locate and download your Verification of Benefits from BenefitsCal. 

Please ensure that you are submitting the complete document.  The VOB must include the Monthly Benefits and Current Household Details section as shown in the example below. 

 



Please upload a copy of your Verification of Benefits HERE:*
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Child 1

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Child 2

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Child 3

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Child 4

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Child 5

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Child 6

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Child 7

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I certify that I have met all of the CARE eligibility requirement listed above. I declare under penalty of perjury that all information on this form is correct. I understand that falsifying or withholding information required on this form is grounds for program disqualification and/or dismissal. Additionally, I authorize the appropriate office/agency to provide the information requested to the CARE program in order to determine eligibility. *
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CARE Staff Verification

Student Status
Applicant is CARE Eligible
CARE MRC
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CARE File Complete
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