If your P-EBT application was denied and you think this was a mistake, please fill out this form. Please complete one form per child.

Please provide information about the parent or guardian.

Please provide an email address if you have one. If you do not provide an email address you will not receive any communications or updates regarding your appeal.

What is the legal name of the child who did not receive P-EBT benefits?


What is the address your school has on file for your child?



What is the school the child attended for the 2019-20 school year?