CalWORKs Forms

As a CalWORKs participant, your county may require you to complete certain hours (22, 32, or 38) per week (unless exempt) in an approved activity. These activity hours are outlined in your Welfare-to-Work (WTW) plan created and agreed on by your case manager (or case worker) and you. The county may, at times, ask for the completion of attendance and progress reports from the institution where you have completed your hours. The following are forms that you may need to complete as a Welfare-to-Work participant:

Attendance Report

This county form is completed each month by the GWC CalWORKs (CW) staff, emailed to the student’s GWC email address for signature (via Adobe Sign), then emailed to the corresponding case manager. It provides county case managers with the following information:

  • Number of class and study-time hours completed for the month
  • Number of absence hours
  • Any course schedule changes (add/drop)

Attendance reports are due to the county case managers between the 1st and 10th of each month. The Orange County version of the attendance report is form 41-6 and the Los Angeles County version is form GN 6365.

Ancillary Request

This is the process GWC CalWORKs staff completes to request funds from the county CalWORKs program for students’ required course materials, supplies, and fees. An ancillary request can be submitted once a student has done the following:

  • Completed their Semester Planning appointment
  • Enrolled in the course(s) on their EEP (Education/Employment Plan)
  • Provided a copy of their semester web bill to GWC CW staff (via email or in-person)

There are two types of ancillary requests; the Advanced Standard Ancillary Payment Request (ASAP) and the regular Ancillary Request.

Advanced Standard Ancillary Payment (ASAP) Request

  • A list of eligible students is submitted to Orange County Social Services CW 15 days prior to the start of the semester
  • Full-time or part-time enrollment status is indicated for each student, and determines the amount of funds provided
  • ASAP funds are disbursed directly to students’ EBT cards

Ancillary Request

  • Submitted to request funds for required campus fees and/or course materials and supplies that exceed the ASAP amount