Do I Qualify for ACP?

Please fill the following pre-qualification form and submit it in order to pre-qualify for the program
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National Verifier FCC Form 5645 online

 

Subscriber Information

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Identity Verification. Please Select One of the following

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Home Address

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Mailing Address

(Only fill this out if it is not the same as your home address)

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Please fill this part if you are qualifying through a child or dependent in your household. If so, answer the following questions:

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Qualifying Beneficiary Identity Verification

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Program Eligibility

Check all programs that you or someone in your household have:

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Tribal Specific Programs

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Disclosures & Authorizations

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Authorizations

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Device Copay Payment 

The Affordable Connectivity Program (ACP) allows qualifying subscribers to claim a one time discount toward a tablet.

The FCC requires us to charge a copay amount.

Our Copay for an Android Tablet with 4G LTE Connectivity  is  a one-time $11.00

(A transaction of $11.00 will be drafted when the prospect subscriber is approved to receive a Tablet)

 

 

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