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LifeLine Internet Benefit Application

  1. Apply online - Submit your Application

  2. Get approved — you'll receive an email within 48 hours with a benefit agreement. 

What is your Date of Birth?
Month
Day
Year
What qualifying benefits do you receive for the Lifeline Credit? (Select all that apply)

**Households on qualifying Tribal lands may receive an enhanced discount of up to $34.25/month. Only one Lifeline benefit is allowed per household. Eligibility is verified through the FCC's National Verifier, operated by USAC.

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*"By submitting this form, you certify that:

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All information provided is true and accurate to the best of your knowledge.

You authorize a Lifeline program representative to contact you via email or phone call to verify eligibility and complete enrollment (if needed).

Questions? Call 888-959-6257

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