Name
Your 900 #
Are you receiving CalWORKs? (Cash Aid)
How long have you been receiving CalWORKs/TANF benefits
Are you part of Moorpark College's EOPS Program?
What is your marital status?
Gender or Child (#1)
Gender or Child (#2)
Gender of Child (#3)
Gender of Child (#4)
By Checking AGREE and typing my name below I understand, and that understand that any false statement made on this application may result in penalties, including, but not limited to being denied CARE services or having to make repayment for services already rendered. By signing below, I acknowledge that all of the information contained in this application for the Extended Opportunities Program and Services is correct to the best of my knowledge.