Single Application Registration Information

In order to use the Web Submission of Single Application for Assistance you must have a valid PA PowerPort user name and password.  If you do not have a PA PowerPort profile, simply fill out the form below and press the "Submit" button.To help provide a more detailed and easier process while  filling out your application we are asking for information that will help us provide you with the best possible programs and screens.

PA Login Information
  Required Fields