ACP Tablet Application

The tablets are funded by the Affordable Connectivity Program (ACP) as long as you receive some type of Government Assistance you will qualify. Additional documentation is sometimes required.

One time activation fee of $15 due at pickup. If arrangements to pick up in person cannot be made there will be an additional fee of $11 for shipping.

Type of Assistance Received
(EBT/SNAP, WIC, MEDICAID, PUBLIC HOUSING, SCHOOL LUNCH, PELL GRANT, VA PENSION/SURVIVOR FUND)
ADDITIONAL DOCUMENTATION AND/OR AWARD LETTER MAY BE REQUIRED TO QUALIFY

If the benefits are in the child's name fill out the information for them below.
Full Name
Date of Birth for Child:

MonthDayYear
Date
Last 4 of Child's SSN:

There are now multiple plan options available! Select the plan you'd like subject to approval.*

Standard Plan (one time fee $15) 15GB monthlyAdvantage Plan (one time fee $25) 25 GB monthly

Thank you for taking the time to complete this application. Once your application has been processed you will be contacted by a representative with a status update. Be sure to hit the submit button to complete the application process.

***There have been a lot of people that are not reading the beginning pages of the application process. You will have to pay a one time fee of $15-$36 depending on the plan you choose.***
Signature*

Clear
Should be Empty:

The tablets are funded by the Affordable Connectivity Program (ACP) as long as you receive some type of Government Assistance you will qualify. Additional documentation is sometimes required.