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FORMS

    LAHC > Student Services > CalWORKS


     Form

    Attachment

    Intake Packet

    Includes: Check List, Release of Client Information Form, GAIN Program/Student Contract, GAIN Orientation Verification Form, Intake Form, Los Angeles Harbor College Rules, Sexual Harassment Policy, Notification of Grievance Complaint Form, Grievance/Complaint Resolution Procedures, Selective Service Registration Form, Change of Information Form, Welfare-to-Work Grant Program Certification Form

    Intake Packet

    PDF

    Book Request Form

    The Book Request Form is used to request the release of funds by your GAIN social worker for textbooks, supplies, and school fees.  Complete the form and return it to the CalWORKs office.

    Book Request Form

    PDF

    Monthly Attendance Report Form

    Monthly Attendance Report forms must be processed by the CalWORKs office. Download and complete the form then return it to the CalWORKs office.

    Monthly Attendance Report Form

    PDF

     Change of Information Form

    If your contact information or GAIN social worker changes please fill out the Change of Information form and return it to the CalWORKs office.

    Change of Information Form

    PDF

     Training Verification Forms

    Training Verification forms are needed to release funds for child care.  Download and complete the Training Verification form and return it to the CalWORKs office.

    Childcare Services


    Parent or Caretaker


    Crystal Stairs
Los Angeles Harbor College - 1111 Figueroa Place, Wilmington, CA 90744 - Tel: 310.233.4000  WEB ADMINISTRATOR - Use of Computing Facilities- LACCD.edu  - Last Updated: 11/8/11