OpporZOOnity Recertify Form

Re‑qualification Form

This form is use to verify your continued eligibility and participation in OppoorZOOnity. Please review all sections carefully and provide accurate up-to-date information.

Eligibility Requirements

To qualify for the OpporZOOnity program, applicants must:
- Hold a valid EBT card
- Residents of Allegheny County, Armstrong County, Beaver County, Butler County, Fayette County, Green County, Lawrence County, Washington County, Westmoreland County, and Somerset County in Pennsylvania.
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.

Contact Information

One name only per form. If a household has multiple EBT cardholders, please submit separate form for each individual EBT cardholder.
OpporZOOnity Program ID Number: *
Enter the ID number under the barcode on your OpporZOOnity card. If you do not have this please enter N/A.
Name*

First NameLast Name
E-mail*
Enter the email you want to receive communications and program status.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Confirm Your Eligibility for OpporZOOnity Program

Applicant 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.
- The cards this program accepts are:
- All uploaded files will be securely deleted after your eligibility has been confirmed.
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 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*

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*

Cancelof
I confirm and certify the information above.
Should be Empty:

Contact Information