Please download both documents, and read the cover letter before filling out the enrollment application form.
To submit the application form, please mail to:
150 Frank H. Ogawa Plaza, Suite 5352, Oakland, CA, 94612
If you are unable to submit the form by mail, please email or text a photo of the form to Everardo Mendoza at emendoza@oaklandca.gov or (510) 388-3970. To protect your privacy, please cover your Social Security Number or Driver's License Number.
For questions about program eligibility, please call (510) 238-3165.