top of page

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)

*

*"By submitting this form, you certify that:

​

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.

Questions? Call 888-977-2003

lifeline internet logo
© 2026 Affordable Connectivity Program - LifeLine Program Internet 
bottom of page