social service programs quechan indian tribe
TRANSCRIPT
December 1, 2020
The Quechan Social Services is seeking available households. Deadline is December 6th, 2020. The Southern California American Indian Resource Center (SCAIR), Inc. will be providing ninety (90) food gift cards to eligible low-income Urban Native Americans families during the holiday season. Gift cards can ONLY be redeemed at Food 4 Less- 2420 Cottonwood Drive, El Centro, CA 92243. Quechan Social Services Department is currently not providing transportation for food gift card utilization in El Centro. Your household MUST have your own transportation available to utilize the food gift card. However, Quechan Social Services is available to assist in filling out and submitting the application and picking up gift cards if transportation is not available at the time of gift card pick up.
In order to receive a gift card:
• Must be an American Indian/Alaskan Native/ Hawaiian Native Household• Families must live in the Imperial County area• Complete the form (Incomplete form will not be accepted)• There is a limit of 3 separate families in one household.• If the gift card is going to be picked up by Quechan Social Services
please write the Quechan Social Services on the top right corner
To apply for the Holiday Food Gift Card:
• Email directly to Octavia at [email protected] Quechan Social services will not have record and permission to pick up your giftcard if you submit your application directly to Octavia
• Email - Contact the Quechan Social Services Office during regular business hours at(760) 572-0201. Emailed applications must be signed by December 6th, 2020.
• To request application via email contactEligibility Worker - Marissa J MillerEmail: [email protected]
• Drop Box - Pick up and drop off packet located outside of the Quechan Social ServicesOffice by December 4th, 2020 at 5:00 PM
Following CDC guidelines, The Social Services Department encourages the community to use alternative forms of communication to reduce in-person contact such as, emails, telephones, etc.,
SOCIAL SERVICE PROGRAMS
Quechan Indian Tribe Fort Yuma Indian Reservation
P. O. Box 1899 Yuma, Arizona 85366-1899
Phone (760) 572-0201 Fax (760) 572-2099
HOWKA PROGRAM
Ninety (90) Food Gift Cards are available for eligible low-income Urban Native Americans! You must pre-register and complete your registration
form by Monday, December 7th at 4pm, to guarantee a gift card. First come, first served.
Elders should not leave their homes during the pandemic and may authorize another individual to pick-up a gift card in their name, after submitting their registration form and notifying our
o�ce of the name of the person who will be picking up.
Food gift card made possible by a Community Service Block Grant through Northern California Indian Development Council. SCAIR, Inc. is a 501(c)(3) Not for Profit Corporation. SCAIR, Inc. respectfully provides Tobacco, Drug, and
Alcohol-Free Events and Activities.
Pick-Up Time for Food Gift Cards:Thursday, December 10, 2020
Noon (12:00pm)
Food 4 Less2420 Cottonwood Drive
El Centro, CA 92243
For more information and to request your registration form,please email Octavia at [email protected].
HOLIDAY FOODGIFT CARDS
Eligibility Form HOWKA Food Assistance Year 2020
Please answer the following questions to determine your eligibility:
Name: _________________________________ SSN: ______________________
Address: ________________________ City/State/Zip: __________________________
Gender: Male Female D.O.B: ________ Phone #:___________________
By signing this document, I certify that I am from an American Indian/Alaskan Native/Hawaiian Native household and am eligible to receive food assistance under the following criteria.
Tribal Affiliation: ______________________________________________
I reside off-reservation in San Diego Imperial Ventura County
I qualify based on my income
INCOME INFORMATION (Please select ALL that apply)
HOUSING INFORMATION
1. Household Type: Single Two Adults (no children) Single Parent Two-Parent Two Adults (with children) Multigenerational
2. Household Size: _______ persons
3. Housing: Own Rent Other Permanent Housing Homeless
Sources of Income: Employment Other Non-Cash Benefits
If you selected “Other”, please specify: TANF SSI SSDI Worker’s Comp. VA Service Related Disability VA Non-Service Related Disability Pension Private Disability Retirement from Social Security Child Support Alimony/Spousal Support Unemployment Insurance
If you selected “Non-Cash Benefits”, please specify: SNAP WIC LIHEAP Housing Choice Voucher Public Housing Public Housing HUD-VASH Permanent Supportive Housing Childcare Voucher Affordable Care Act
Annual Income: $________________
___Quechan Social Services
Other:_________________
Education Level: Primary (K-12) ________ grade High School Graduate/Equivalency Diploma
Some Post-Secondary College Graduate (2 or 4 years)
Other Post-Secondary Graduate
Ethnicity: Hispanic/Latino/Spanish Origin Not Hispanic/Latino/Spanish Origin
Military Status: Veteran Active Military Non-Military
Work Status: Full-Time Employ Part-Time Employ Migrant Seasonal Farm Work
Unemployed (6 months or less) Unemployed (more than 6 months)
Unemployed (not in workforce)
Signature: _________________________________ Date: _______________________
Please select
HIGHEST level of
education ONLY