Apply Via Mail
Prefer to apply through mail? Please download and complete the below form, make a copy of your qualification documents and mail to:
Quality Assurance Department
East Mountain Corporate Center
100 Baltimore Drive
Wilkes Barre, PA 18702
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Personal/Photo Identification
Public Assistance Documentation
Please upload one (1) form of Primary identification OR two (2) forms of Secondary identification:
PRIMARY IDENITIFICATION
- Current US, Mexican or Canadian driver’s license or state photo ID or expired photo driver’s license which is not more than five (5) years old from the expiration date.
- Current US Passport
- Current Foreign Country Passport
- Current photo US Military ID/Merchant Marine card
- Current photo US Military Dependent card
- Valid Resident Alien Card Permeant Resident Card (INS Form I-551)
- Certification of US Citizenship (N-560 or N-561)
- Certification of Naturalization (N550, N-570, or N578)
- Employment Authorization Documentation (INS Form I-688 or I-766)
- Photo employment ID card issued by US Government agency prison ID cards are not acceptable
- Current Welfare/Social Services photo ID card
SECONDARY IDENITIFICATION
- Non-photo driver’s license
- US Department of State Non-Immigrant Visa
- Social Security card
- Court demand in applicant’s name – must contain full name, date of birth (DOB), court seal
- Examples: Marriage certificate, Divorce degree, Legal name change
- Current weapons or gun permit with photo
- Current school photo ID card
- Medicare/Medicaid card
FILE FORMATS
The following file formats are accepted with maximum file size of 7 MB each.
- .JPG (JPEG Image File)
- .TIFF (Tagged Image File Format)
- .GIF (Graphical Interchange Format File)
- .PNG (Portable Network Graphic)
- .PDF (Portable Document Format File)
- .DOCX (Microsoft Word Open XML Document)
- .DOC (Microsoft Word Document)
Please upload one (1) or more of the following forms of assistance program documentation. Documents must be from 2020 or 2019:
- MEDICAID: card or most recent eligibility letter for an adult in your household.
- Public housing assistance documentation such as your lease, housing assistance payment (HAP) contract, or eligibility documentation from HUD.
- SNAP: letter indicating you are approved for Supplemental Nutrition Assistance Program benefits.
- TANF: eligibility letter for Temporary Assistance for Needy Families.
- SSI: eligibility letter for Supplemental Security Income.
- NSLP/Head Start: copy of a letter indicating current participation in the National School Lunch Program or Head Start, with your child’s name, the school name, and the address of where you are requesting service.
- LIHEAP: letter confirming your eligibility for Low Income Home Energy Assistance Program.
- WIC: eligibility letter for the Women, Infants, and Children program.
- FEDERAL PELL GRANT: (Colorado and Illinois only) documentation from your community college’s financial aid office.
- VA PENSION: veterans pension eligibility determination letter from the Veterans Administration.
- Tribal assistance eligibility letter, including TTANF, FDPIR, etc.
FILE FORMATS
The following file formats are accepted with maximum file size of 7 MB each.
- .JPG (JPEG Image File)
- .TIFF (Tagged Image File Format)
- .GIF (Graphical Interchange Format File)
- .PNG (Portable Network Graphic)
- .PDF (Portable Document Format File)
- .DOCX (Microsoft Word Open XML Document)
- .DOC (Microsoft Word Document)
