Form Wtw Eoa1 - Calworks Educational Opportunity And Attainment (Eoa) Program Application Form
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1State of California – Health and Human Services Agency
California Department of Social Services
CALWORKS EDUCATIONAL OPPORTUNITY AND ATTAINMENT (EOA)
PROGRAM APPLICATION FORM
COUNTY OF
________________________
Case Name
Case Number
Worker Name
Worker Number
The CalWORKs EOA program is not an entitlement program. Funding is limited and once
exhausted, no additional applications will be accepted.
Check one
I, ________________________, am applying for a $500 once in a lifetime cash payment
education incentive that is awarded for the completion of a high school diploma or its equivalent
achieved on or after January 1, 2018.
I, ________________________, am applying for a $1000 once in a lifetime cash payment
education stipend that is awarded for enrollment in a term of an education or training program that
started on or after January 1, 2018.
This new program is intended to provide incentives to encourage and support CalWORKs
recipients to pursue education and improve the opportunities and outcomes for adults and
their children in the CalWORKs program.
Initial Each Item
______ You may be able to get the once in a lifetime bonus of $500 for graduating from high school or
its equivalent on or after January 1, 2018. Cal-Learn teens are not eligible for this $500 high
school bonus.
______ You may be able to get the once in a lifetime $1,000 stipend payment if you enrolled in an
education or training program designed to lead to a career technical education program
certificate, or a college degree program that started on or after January 1, 2018.
______ To get the $500 education bonus or $1,000 stipend payment you must give your county proof
that you graduated from high school, its equivalent, or enrolled in an education or training
program designed to lead to a career technical education program certificate, or a college
degree program.
______ You can only get the $500 education bonus and $1,000 stipend payment once in a lifetime
when you are a CalWORKs recipient.
______ You cannot get the $500 education bonus and/or $1,000 stipend payment in any month that
you are sanctioned or removed from CalWORKs cash aid for not complying with Welfare-to-
Work rules.
______ You cannot get the $500 education bonus and/or $1,000 stipend payment if you have no time
left on your CalWORKs 48-month time limit.
______ You cannot get the $500 education bonus and/or $1,000 stipend payment if you have
committed public assistance fraud.
______ The county must verify your diploma, its equivalent, or enrollment.
______ The education or training program designed to lead to a career technical education program
certificate, or a college degree program must be in your approved Welfare-to-Work plan.
Signature Of CalWORKs Recipient
Date
WTW EOA1 (11/17) REQUIRED FORM – NO SUBSTITUTE PERMITTED
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