Basic Needs Request

If you are a current Feather River College student who is facing challenges with accessing basic needs such as adequate food, stable housing, general hygiene or wellness products you're encouraged to complete this from. This form will be used to connect you with resources related to your identified areas of need.

Name Name First Last
Preferred name
Student ID # (900)
I identify as

I identify as Male Female Non-Binary Prefer not to disclose Other Other
Phone Phone - ### - ### ####
Email
Email Confirmation
Preferred method of contact

Preferred method of contact phone call email text
Are you currently enrolled at FRC?

Are you currently enrolled at FRC? Full-time Part-time No
Have you completed FASFA or the Dream Act Application (CADAA)?

Have you completed FASFA or the Dream Act Application (CADAA)? Yes No
Do you have children between the ages of 0-18 living with you?

Do you have children between the ages of 0-18 living with you? Yes No
Check all programs/services you receive, participate, or identify with

Check all programs/services you receive, participate, or identify with CalWorks DSPS EOPS/Care SSS Trio Foster Youth Veteran Services Child Development Center (CDC) CalFresh International Student N/A Other Other
What basic need service are you seeking assistance with?

What basic need service are you seeking assistance with? Food Housing Transportation Mental Health Child Care Hygiene Technology Support Physical Health Coats/Clothing Diapers/Wipes Other Other
How did you hear about FRC Basic Needs Services? (select the most applicable)

How did you hear about FRC Basic Needs Services? (select the most applicable) FRC website FRC App Email Communication Social Media Class Announcemnt Other Other