Low income Internet Program
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Lifeline, ACP or ACA Experience?
*
Lifeline
ACP
ACA
Are you able to pass a background check? Service providers require you to pass a background check in order to receive logins. If you’re unable to pass, unfortunately, you will not qualify to become an outreach representative.
*
Yes
No
Do you currently have a location?
*
Yes
No
Everyone connected does not provide locations. We do provide help if anything is needed from the company in order to assist with acquiring a space, and depending on the location, we can also contribute to paying for it. Are you willing to find your own location?
*
Do you have reliable transportation?
*
Do you have a phone or a tablet to submit applications?
*
Bilingual
*
Please Select
YES
NO
Anything we should know about you experience or what you're currently doing?
Submit
Should be Empty: