Locally owned wireless broadband internet.

Lifeline Program Sign Up

Name

If the applicant is under 18, the Household must be enrolled in Lifeline.

First Name

Last Name

DOB

What are the last 4 numbers of your Social Securiy Number?

Street Address

Must be the service address and the applicants name must be associated with this address.

City

Zip Code

Are you applying as an Individual or as a Household?