diff --git a/benefits/in_person/templates/in_person/eligibility.html b/benefits/in_person/templates/in_person/eligibility.html
index e69de29bb..c808567e1 100644
--- a/benefits/in_person/templates/in_person/eligibility.html
+++ b/benefits/in_person/templates/in_person/eligibility.html
@@ -0,0 +1,80 @@
+{% extends "admin/base.html" %}
+{% load i18n static %}
+
+{% block extrastyle %}
+    <style>
+        html[data-theme="light"], :root {
+          --primary: #045b86;
+          --secondary: #045b86;
+          --link-fg: #ffffff;
+          --body-quiet-color: #000000;
+        }
+        html[data-theme="dark"], :root {
+            --primary: #045b86;
+            --secondary: #045b86;
+            --link-fg: #ffffff;
+            --body-quiet-color: #000000;
+          }
+    </style>
+    <link href="https://fonts.googleapis.com/css?family=Roboto:400,500,700" rel="stylesheet" type="text/css">
+    <link href="https://california.azureedge.net/cdt/statetemplate/6.0.7/css/cagov.core.min.css" rel="stylesheet">
+    <link href="{% static "css/styles.css" %}" rel="stylesheet">
+    <link href="{% static "img/favicon.ico" %}" rel="icon" type="image/x-icon" />
+{% endblock extrastyle %}
+
+{% block title %}
+    Agency Dashboard
+{% endblock title %}
+
+{% block branding %}
+    <div id="header-container" class="navbar navbar-expand-sm navbar-dark bg-primary justify-content-between">
+        <div class="container">
+            <span class="navbar-brand p-0">
+                <img class="sm d-lg-none" src="{% static "img/logo-sm.svg" %}" width="90" height="51.3" alt="{% translate "California Integrated Travel Project: Benefits logo (small)" context "image alt text" %}" />
+                <img class="lg d-none d-lg-block" src="{% static "img/logo-lg.svg" %}" width="220" height="50" alt="{% translate "California Integrated Travel Project: Benefits logo (large)" context "image alt text" %}" />
+            </span>
+        </div>
+        <h1 class="p-0">Administrator</h1>
+    </div>
+{% endblock branding %}
+
+{% block coltype %}
+    w-100 row justify-content-center
+{% endblock coltype %}
+
+{% block bodyclass %}
+    {{ block.super }} dashboard
+{% endblock bodyclass %}
+
+{% block nav-breadcrumbs %}
+{% endblock nav-breadcrumbs %}
+
+{% block nav-sidebar %}
+{% endblock nav-sidebar %}
+
+{% block content_title %}
+{% endblock content_title %}
+
+{% block content %}
+    <div class="col-lg-6">
+        <h1 class="pt-0 pb-3 text-left">{{ agency.long_name }}</h1>
+        <div class="border border-3 p-3">
+            <h2 class="pt-0 pb-2 text-left">In-person enrollment</h2>
+        </div>
+        <div class="border border-3 border-top-0 p-3">
+            <p class="pt-0 pb-2 text-left">Choose an eligibility type to qualify this rider:</p>
+            <div class="row pt-4">
+                <div class="col-6">
+                    <a href="#" class="btn btn-lg btn-outline-primary d-block">Cancel</a>
+                </div>
+                <div class="col-6">
+                    <a href="#" class="btn btn-lg btn-primary d-block">Continue</a>
+                </div>
+            </div>
+        </div>
+    </div>
+
+{% endblock content %}
+
+{% block sidebar %}
+{% endblock sidebar %}
diff --git a/benefits/static/css/styles.css b/benefits/static/css/styles.css
index 91b71c0b3..b6074e451 100644
--- a/benefits/static/css/styles.css
+++ b/benefits/static/css/styles.css
@@ -370,6 +370,14 @@ footer .footer-links li a.footer-link:visited {
 
 .btn.btn-lg.btn-primary {
   background-color: var(--primary-color);
+}
+
+.btn.btn-lg.btn-outline-primary:not(:hover) {
+  color: var(--primary-color);
+}
+
+.btn.btn-lg.btn-primary,
+.btn.btn-lg.btn-outline-primary {
   border-color: var(--primary-color);
   border-width: 2px;
   font-weight: var(--medium-font-weight);