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Hey! I'm Olivia, Your Benefits Coordinator.
Please complete the following:

What is your housing status?

Rent Own Live with relatives or friend University residence Homeless / Living in a Shelter

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What is your employment status?

Employed Unemployed Homemaker Student Retired Military Unable to work / Disabled

What is your education level?

Did not graduate high school High school diploma/GED Some college completed Graduated college Graduate degree or above

What is your gender?

Female Male Prefer not to say

What is your date of birth?

(You must be 18 years or older to receive benefits.)

What is your address?

(Benefits may vary by location)

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