Pre-SNAP Eligibility 1Applicant Information2Student Specific Info3Household Expenses4Utilities5Current Benefits Let's get the basics!Full Legal Name* First Middle Last CSU ID* Phone Number*Email Address* Date of Birth* MM slash DD slash YYYY Are you currently residing in Colorado?* Yes No If residing in Colorado, what county?* Number of Persons Applying for Benefits:*Earned Monthly Income (Before Taxes):* (Wages from job, stipend, etc.)Unearned Monthly Income (before Taxes)* Unearned Monthly Income (before Taxes) You do not need to be a student to utilize this service!Are you enrolled in the current semester (Fall, Spring, Summer)? Yes No If currently enrolled, how many credits are you taking? Are you under the age of 22 and living with a parent or guardian? Yes No Does a meal plan pay for more than 50% of your meals? Yes No How many hours (on average) do you work per week? Do you have a work-study award? Yes No Are you a parent or caregiver? Yes No (Rent/Mortgage, Property Taxes, Home Insurance, Child or Adult Daycare)Rent/Mortgage Payment (monthly) Home Insurance Property Taxes Child/Adult Daycare (Gas, Electric, Trash, Water, Phone, Other)Gas/Electric Bill Water Bill Trash Bill Phone Bill Other Are you currently receiving benefits through PEAK (Medicaid, SNAP, WIC, TANF, LEAP)Are you currently receiving benefits through PEAK? Medicaid SNAP WIC TANF LEAP I don't know No