CalFresh Benefits

See if you qualify today!

Apply For CalFresh Benefits

"*" indicates required fields

Are you filling out this form for yourself?*

Yes

Referring Agency Contact First Name*

Referring Agency Name*

Referring Agency Contact Last Name*

Email*

Client First Name*

Client Last Name*

Resident of Santa Cruz County?*

Yes

Date Of Birth*

Client City and Zip Code*

City ZIP Code

Phone*

Email Address

Are you currently receiving any of the following:*

CalWORKs

MediCal

SSI/SSP

None of the above

Please let us know your preferred appointment time.

8 a.m.

9 a.m.

10 a.m.

11 a.m.

1 p.m.

2 p.m.

3 p.m.

Please contact me for an appointment time.

How did you hear about us?

Any other comments...

This field is for validation purposes and should be left unchanged.

You may qualify for Calfresh if you can answer yes to all of these questions:

(Note: If you or a family member are 60 years or older or permanently disabled, your gross income limit will be higher.)

800 Ohlone Parkway
Watsonville, CA 95076