Applicant Chart
- Name
- If you are the adult in the household, then your name goes here. Do not put your children’s or grandchildren’s names on this line.
- If you are under the age of 22, but do not live with your parents or other adult who is legally responsible for you, then your information will go here. (For example, if you are a teenager living with a family friend or an older sibling, then you may apply on your own.)
- If you are under the age of 22 and live with your parents, you are required to include your parents, stepparents, and all siblings under the age of 22 who live in the home. This means you must also include everyone’s income.
- Street Address
- The street address is where you currently stay.
- If you are homeless, you may state you are homeless.
- Are you homeless?
- This is mainly for statistical purposes and just gives the case manager a better understanding of your circumstances. You will not get more Food Stamps if you are homeless.
- Mailing Address
- If your mailing address is different from your street address, be sure to include your mailing address here. If they are the same, you may write “SAME” in this area or leave it blank.
- If you are homeless, you may talk to a local homeless shelter about using their mailing address as your own if you do not have other options. You may also use the DFCS address, but remember that you are still responsible for keeping up with your renewal dates.
- Main telephone number
- All Food Stamp cases have a telephone interview once a year.
- A dependable phone number with service and voicemail helps insure your chances you will get a phone call.
- Other telephone number
- You have the option of including a second phone number such as a work number, a family member, or friend’s number.
- If you use someone else’s number, that person cannot complete your interview unless you have submitted them as an authorized representative and have provided the correct documentation allowing them to serve as your representative.
- Electronic communication
- This gives consent to receiving email or text communication.
- You cannot complete a Food Stamp interview through email or text.
- Only choose these options if you regularly check your texts or email.
- What is your preferred language?
- All government agencies are required to provide a language interpreter if necessary.
- If you prefer to speak in a language other than English, list it here.
- (This blog is not a government agency. I do not speak another language and cannot provide alternate languages.)
- Will you need an interpreter?
- You and your case manager need to be able to communicate effectively, so check yes if you need an interpreter.
- DFCS can provide an interpreter if you do not have your own.
- You may provide your own interpreter if you prefer. You will need to complete a form verifying you have brought your own interpreter.
- Children under the age of 18 may not serve as an interpeter.
Americans with Disabilites Act
- The Americans with Disabilities Act requires that all government agencies provide accommodations if you have a disability.
- You are not required to complete this section, but it helps you if you do have a disability.
- Check “yes” if you have a disability and then check any assistance you may need.
- Accommodations include:
- Sign Language Interpreter
- TTY
- Large Print
- Electronic Communication (by email)
- Braille
- Video Relay
- Cued Speech Interpreter
- Oral Interpreter
- Tactile Interpreter
- Telephone Reminder of Deadlines
- Telephonic Signature
- Face-to-face interview (Home Visit)
- Other (list needed accomodation)
- Audio Description Services
- Accessible Transport
- Assistance with Filling Forms
- Personal Care Assistant
- Adaptive Equipment
- Extended Deadlines
- Flexible Scheduling
- Support Animal
- Specify if you need the accomodation one time or if you will continue to need it.
- If you can, specify how, when, and how long you will need the accommodation if you can.
