Los Angeles Harbor College CalWORKs Program
Intake:
LACCD CalWORKs Intake Application.pdf
Solicitud de CalWORKs (español).pdf
STEP 1: Complete
STEP 2: Sign each page
STEP 3: E-mail the the Intake Forms to any counselor or coordinator:
Program Specialist/Coordinator: Angeles Zesati: @email
Counselor: Angel Cristales: @email
Counselor: Kaitlin Morales: @email
Counselor: Janette Jimenez-Toriz: @email
Monthly Attendance Report:
STEP 1: Complete the form and attach your class schedule (current semester).
STEP 2: Sign bottom portion
STEP 3: E-mail the MAR to any counselor or coordinator:
Program Specialist/Coordinator: Angeles Zesati: @email
Counselor: Angel Cristales: @email
Counselor: Kaitlin Morales: @email
Counselor: Janette Jimenez-Toriz: @email
Ancillary Request:
The Ancillary Request Form is to request the release of additional funds by your GAIN services worker for textbooks, supplies, and school fees. Please complete the following steps to request textbooks, supplies etc.
STEP 1: Complete and sign the form
STEP 2: Attach your class schedule (current semester).
STEP 3: E-mail the Ancillary Request to any counselor or coordinator:
Program Specialist/Coordinator: Angeles Zesati: @email
Counselor: Angel Cristales: @email
Counselor: Kaitlin Morales: @email
Counselor: Janette Jimenez-Toriz: @email
Progress Report:
GN 6070 Español (fillable. pdf)
STEP 2: Sign bottom portion
STEP 3: E-mail the GN 6070 to any counselor or coordinator:
Program Specialist/Coordinator: Angeles Zesati: @email
Counselor: Angel Cristales: @email
Counselor: Kaitlin Morales: @email
Counselor: Janette Jimenez-Toriz: @email
Change of Information
If your contact information or GAIN services worker changed, please let us know!