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CalWORKs Mutual Responsibility Contract
CalWORKs Mutual Responsibility Contract
Student Name
First
Middle
Last
Student B Number
CalWORKs PROGRAM SERVICES
As a CalWORKs student, you may be eligible for the following services.
All program services may not be duplicated and
are based on program and funding availability.
Priority Enrollment and Registration Assistance
Academic/Personal Advising and Counseling
Textbook Assistance
Transportation Assistance
School Supplies
Tutorial Services Assistance
Financial Aid Application Assistance
Cultural/Education Enrichment Activities
Campus and Community Referrals
Career Assessments and Readiness Training
On/Off-Campus Job Opportunities
CalWORKs STUDENT REQUIREMENTS
I must enroll in and complete six (6) units in Spring/Fall (Summer is an optional semester for continuing students)
I must complete three (3) required contacts every semester as indicated in the SPS Deadline Dates.
One (1) Staff Contact:
Meet with assigned CalWORKs staff one (1) time per semester.
Two (2) Counseling Contacts:
Meet with assigned CalWORKs counselors two (2) times each semester.
General counseling and
drop-in counseling do not satisfy a counseling contact.
I must attend one (1) career focused workshop. I must submit a workshop form with the moderator's signature and include a paragraph summary of what I learned if I choose to attend workshops.
I am eligible to receive CalWORKs services until I have completed my degree.
I understand that appointment reminder alerts/phone calls are a courtesy and are not guaranteed. I must contact the CalWORKs office if I cannot make any of my scheduled appointments. If I need to reschedule a contact, available days/times may be limited.
I must notify program staff of any changes to my class schedule and units. If I change my address or phone number, I must update this information with Admissions or Online via my single sign-on portal.
I understand that all CalWORKs support services that I receive will be reported to Financial Aid.
I must re-certify for CalWORKs every semester by providing a recent Verification of Benefits.
I must attend a mandatory orientation once per academic year to be updated on program requirements.
By signing below, I verify that I understand and agree to fulfill all CalWORKs Program Requirements. I understand that failure to do so may result in probation or program dismissal, or a hold being placed on my account.
Signature Waiver
By checking this box I understand that typing my name will be considered my official electronic signature
Student Signature
Date
CalWORKs Staff Signature
Date
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