Please help us by completing the following survey - your cooperation is vital.  The information will help ensure that SRJC continues to receive adequate funding from the state for career technical education programs.  YOUR RESPONSES WILL BE TREATED WITH COMPLETE CONFIDENTIALITY.  Please be sure to answer all survey questions, then click the SUBMIT button at the bottom of the page when you are through.  Thank you.
Q1 Please enter your 9-digit student ID number carefully in the box: Q2 Are you a single parent? (A "single parent" is a person with custody - including joint custody - of a child or children, or a person who expects to be a single parent within the next year due to pregnancy.)   Yes   No Q3 Are you a displaced homemaker?  (A "displaced homemaker" is an adult who has worked to care for home and family and because of this responsibility is currently unable to find a job, or better paying job, due to lack of training or labor market experience.)   Yes   No Q4 Are you a dislocated worker?  (A "dislocated worker" is one who has been laid off from full-time employment within the last 24 months.)   Yes   No		Q5 Are you receiving any of the following types of aid:   Yes   No   CalWORKs/TANF (formerly AFDC)     SSI - Supplementary Security Income     GA (General Assistance)     Section 8 Housing Assistance     Foster Care   Q6 Please use the table below when you answer this question to assess your eligibility for a Board of Governors (BOG) fee waiver.   Does your family income level qualify you for a Board of Governors (BOG) fee waiver based on the number of people in your family and your 2011 Total Family Income (Adjusted Gross Income and/or untaxed income)?       Yes, I qualify based on the table below No,  I do not qualify based on the table below. Family Size                        2011 Income was less than: 1 (yourself only).................................$16,335 2........................................................$22,065 3........................................................$27,795 4........................................................$33,525 5........................................................$39,255 6........................................................$44,985 7........................................................$50,715 For each additional family member, add $5,730