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Find out if you qualify
The Affordable Connectivity Program (ACP) is a federal benefit that helps pay for internet service and devices. Fill out the application below to see if you PRE-QUALIFY for your TABLET and 5 years of free internet service.
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* Indicates required question
Full Name (Adult not the child)
*
Your answer
Phone Number
*
Your answer
Address (Must match benefits) Ex: 1234 Main St, Houston TX 77004
*
Your answer
Date Of Birth (Adult not the child)
*
MM
/
DD
/
YYYY
Email
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Your answer
Last 4 digits of Social
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Your answer
Have you received a free government phone in the past 12 months?
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Yes
No
Have you received a free government tablet in the past 12 months?
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Yes
No
Which government benefit do you receive?
*
Federal Public Housing Assistance
Food Stamps
Household income is at or below a certain amount (e.g. $55,500/year for a family of four, $27,180/year for an individual).
Medical Assistance /Medicaid
Supplemental Security Income (SSI)
Temporary Assistance for Needy Families (TANF)
Tribal Early Learning Initiative (Income Qualifying)
Veterans Pension
School Lunch/Breakfast Program
Federal Pell Grant
Special Supplemental Nutrition / Women, Infants, and Children (WIC)
Required
If approved, can you provide PROOF of your benefits?
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Yes
No
If approved are you able to pay $20 set up fee?
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Yes
No
Do you have any other friends or relatives that would be interested in this program?
*
Yes
No
NAME of the person who referred you to the program? This is your point of contact to receive your FREE Tablet
*
Your answer
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