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STEP 2
Residence Address*
Select State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
STEP 3
Date of birth*
Have you applied with the Program before?
YES
NO
Select Government Benefit*
Food Stamps (SNAP)
Medicaid
Social Security
SSI
Federal Public Housing (section 8, HUD housing, etc..)
Tribal Benefits
Federal Pell Grant
Veteran's Pension
WIC
Or your yearly income is 60,000 or less
STEP 4
Sign by typing your name below:
I agree to the
terms of service
and
privacy policy
.
Verify benefits and delivery through SMS
I have reviewed the
ACP Consent
here in and consent to all. I consent to my electronic signature be used to complete the required documentation to enroll in the Affordable Connectivity Program.
I acknowledge that my PII will be transferred to NLAD to complete my ACP enrollment.
100,000+ Already Enrolled
IMPORTANT: A verification of enrollment will be sent to you by text. Please verify your mobile number is correct
