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Basic Needs Request
Basic Needs
refers to the most essential resources required to thrive as a student. This could include access to nutritious food, stable housing, transportation resources, and financial wellness resources. OCC students who are facing challenges with their access to basic needs, please complete this form. After completing this form, students will:
Connect you with supportive staff for a Basic Needs Consultation
Provide individual resource suggestions and referrals to campus and community support
Receive direct aid or access to the Pirates' Cove Food Pantry or Clothing Closet
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Student Information
OCC Student ID
First Name
Preferred Name
Last Name
Email Address
Phone Number
Date of Birth
Date of Birth
January
February
March
April
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September
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December
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Preferred Method of Communication
Preferred Method of Communication
Email
Phone
Text
What are you preferred pronouns?
What are you preferred pronouns?
He/him/his
She/her/hers
They/their/theirs
Other:
Other
Basic Needs Assessment
I need support with (select all that apply)
I need support with (select all that apply)
Child Care Resources
Clothing Resources
Employment Resources
Food Resources
Health Resources
Housing Resources
Hygiene Resources
Shower and Locker Room
Transportation Resources
Other:
Other:
Transportation Resources
What kind of Transportation Resource would be helpful (select all that apply)?
What kind of Transportation Resource would be helpful (select all that apply)?
Gas Card
Parking Pass
Bus Pass
Other:
Other:
Students can request one $50 gas card for the semester if they meet the following eligibility criteria:
Currently enrolled at OCC,
Eligible for the California College Promise Grant fee waiver
Not part of any other campus program that offers transportation assistance
Students can receive assistance with purchasing a semester parking pass if they meet the following eligibility criteria:
Currently enrolled at OCC
Eligible for the California College Promise Grant fee waiver
Not part of any other campus program that offers a parking pass
OCC offers currently enrolled students a free bus pass via the OC Bus App. If you need help accessing the app or do not have a mobile phone, please visit the
OCC Basic Needs Center
.
Submit
