Cuesta College Foster Youth Resource Checklist
Please answer the questions below regarding the resources you are currently involved with. This will allow Cuesta to identify what resources you may be eligible for and which agencies you are already working with.
Full Name:
*
First Name
Last Name
Student ID#:
*
myCuesta Email:
*
Phone Number:
-
Area Code
Phone Number
Birth Date:
*
-
Month
-
Day
Year
Date Picker Icon
How old were you when you left Foster Care?
With which resources are you currently involved?
Independent Living Program
TAY-FAP (Transitional Age Youth Financial Assistance Program)
EOPS (Extended Opportunities Programs & Services)
THP-Plus (Transitional Housing Program Plus)
Lisa Allardyce (College Counseling Specialist)
Case Worker:
First Name
Last Name
Do you receive any of the following benefits?
Medi-Cal (CenCal)
Financial Aid
CHAFEE Grant
SNAP Benefits (Food Stamps)
Please check all items for which you need more information.
EMERGENCY:
Food
Shelter
Medical
TRANSPORTATION:
Car Repair
Bus Fare
Fuel
MENTAL HEALTH:
Anxiety
Depression
Eating disorder
Parenting
LGBTQ issues
Anger
Grief
Phobias
Stress
Transitional issues
Substance abuse
Domestic violence
Marital and family issues
PHYSICAL HEALTH:
Check up
Eye exam
Hearing testing
Well woman exam
HOUSING:
Deposit
Rent
Utilities
EDUCATIONAL SUPPLIES:
A computer for class work
Classroom materials
Other
If you selected other, please specify:
CUESTA RESOURCES:
Academic Counseling
Disabled Student Programs and Services (DSPS)
Extended Opportunity Programs & Services (EOPS)
Financial Aid
Veterans' Services
Have you ever been diagnosed with a disability?
Yes
No
If yes, please explain:
Have you ever had difficulties in the classroom?
Yes
No
If yes, please explain:
Where you in resource classes?
Yes
No
While in high school did you have an IEP or 504 plan?
Yes
No
ASSISTANCE:
Addressing Legal Issues
Getting CA Photo ID/Driver’s License
Getting Birth Certificate
What activities would you like to see?
Virtual games
Resource workshops
Social gatherings/mixers
Other
Submit
Should be Empty: