Paper Applications
Below is the application for those who are choosing to mail their Lifeline application. However, to speed things up, you can also enroll online!
Along with your application, send a copy of:
1) Your government issued photo ID or driver’s license.
2) An Eligibility Document.
IMPORTANT
Household Worksheet
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Oregon Household Worksheet
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Oregon Tribal Household Worksheet
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You will be able to submit these documents as part of your application. Rest easy because your documents are always 100% protected under our Privacy Policy.
All NLAD states may enroll by mail using this application.
NLAD opt-out states – California*, Oregon, and Texas please use the links below.
*Service providers in California with broadband-only subscribers must use NLAD to enroll these subscribers.
*All forms of ID must be valid and used before expiration date.
Qualify by income and provide one of the following as proof.
BIA Award letter, should contain the following basic information:
Head Start Award letter, should contain the following basic information:
TANF Award letter, should contain the following basic information:
Notice of Action (award letter) acknowledging eligibility for FDPIR benefits;
OR
FDPIR participation documents(e.g., a benefit card or copy of a benefit card);
Due to sharing many of the same eligibility requirements those currently enrolled in the lifeline program may qualify for The Affordable Connectivity Program (ACP) also.
Program Approval Letter, Benefit Statement, or Verification of Coverage Letter, should contain the following basic information:
OR
Eligibility Screenshot or printout from an online portal or website tool, should contain the following basic information:
Program Approval Letter, Benefit Statement, or Verification of Coverage Letter, should contain the following basic information:
OR
Eligibility Screenshot or printout from an online portal or website tool, should contain the following basic information:
Pension Grant Letter should contain the following basic information:
FPHA award letter should contain the following basic information:
Approval Letter or Benefit Statement issued by the SSA or on SSA letterhead.
Program Approval Letter, Benefit Statement, or Verification of Coverage Letter should contain the following basic information:
OR
Eligibility Screenshot or printout from an online portal or website tool should contain the following basic information:
Program Approval Letter, Benefit Statement, or Verification of Coverage Letter should contain the following basic information:
OR
Eligibility Screenshot or printout from an online portal or website tool should contain the following basic information:
If you, or one of your dependents, participate in one of these programs, your household may be eligible for the federal government Lifeline supported benefits.
Supplemental Nutrition Assistance Program (SNAP) | Supplemental Security Income (SSI) |
Medicaid | Veterans Pension and Survivors Benefit |
Federal Public Housing Assistance (FPHA) | Food Distribution Program on Indian Reservations (FDPIR) |
Tribally Administered TANF | Bureau of Indian Affairs General Assistance |
Tribally Administered Head Start (Meeting the income-qualifying standards of Head Start) |
*All forms of ID must be valid and used before expiration date.