OpporZOOnity Registration Form

Residency Requirements

Applicants must hold a valid EBT card and reside in select Pennsylvania counties—enter your zip code below to continue.
Please enter your zip code below to check eligibility.
Valid Zip Code
Unfortunately, based on the eligibility criteria, you do not qualify for participation at this time.

If you believe this decision was made in error or have any questions, you may try submitting the form again or contact us at 412-665-3640 or OpporZOOnity@gmail.com.
Your ZIP code matches the eligibility criteria.

Click Next to continue with the registration form.

Hello and welcome!

To apply for the OpporZOOnity program, applicants must hold a valid EBT card and reside in select Pennsylvania counties.

To complete your application, please upload:
- A photo of your EBT card
- A photo ID that matches the name on the EBT card. The ID must also show an address within one of the accepted Pennsylvania counties.
  
  The cards this program accepts are
Please note: The review process may take 5–10 business days, after which you will be notified if your application has been approved or denied.
Agreement*

I have read and understand the program requirements. I confirm that the information and documents I provide are accurate and agree that my application may take 5–10 business days to review. I understand that eligibility is not guaranteed.

Contact Information

One name only per form. If multiple Electronic Benefits Transfer (EBT) cardholders are in a household a separate form will need to be submitted.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Applicants must be over the age of 16 with valid photo ID that matches the name on the EBT/SNAP card.
E-mail*
Enter the email you want to receive communications and program status.
Phone Number*
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Zip Code*
Please enter a valid U.S. ZIP code (e.g., 12345)

Demographic Information

We ask these questions to help ensure that our services and programs meet the needs of our diverse community. Providing this information is completely optional and will not affect your participation.
How many children are in your household (aged 17 or younger)?
Which of the following best describes your race or ethnicity?

American Indian or Alaskan NativeAsianBlack or African AmericanHispanic, Latino, or Spanish originMiddle Eastern or North AfricanNative Hawaiian or Other Pacific IslanderWhite / CaucasianPrefer not to answerOther

Household Members
Will another member of your household who has an EBT card be submitting a separate registration form?*

YesNo
What is the full name of the additional person in your household submitting this form?
Enter Full Name
What is your relationship?

Spouse/PartnerParent/Legal GuardianChildSiblingFamily MemberOther

Confirm Your Eligibility for OpporZOOnity Program

Applicants must submit a valid EBT card and government-issued photo ID for verification. Both the card and ID must match to be accepted
We take your privacy seriously. The documents you upload will only be used to verify your membership in the EBT program. All uploaded files will be securely deleted after your eligibility has been confirmed.

The cards this program accepts are:

To confirm your eligibility for the program, please upload:
1. A photo of your EBT card
2. A photo ID that matches the name on the EBT card and address must be in one of the accepted Pennsylvania counties.
If you have concerns or need assistance, please contact us at contact us at 4 OpporZOOnity@gmail.com
Upload your EBT card

Make sure the images are clear and all text is legible. Accepted file formats: JPEG, PNG, or PDF.
Upload EBT card*

If this does not match the type of cards the program accepts your application will be denied.
Cancelof
Upload your Photo ID

Make sure the images are clear and all text is legible. Accepted file formats: JPEG, PNG, or PDF.
Upload photo ID*

If this does not match the name on the EBT card your application will be denied. Address on the ID and form submission must match as well.
Cancelof

I confirm that I have read the instructions, uploaded both required documents, and understand that failure to follow them may result in denial. I also certify that I meet the eligibility requirements for this financial needs‑based program and that all information and contact details I have provided are true and complete.*

I confirm and certify the information above
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Residency Requirements