ACP Enrollments

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Choose Service State: *

NLAD/USAC Application ID: *

Are you currently enrolled with any other ACP provider? *

Service Type: *

Today's Date: *

First Name: *

Middle Name:

Last Name: *

Suffix:

Last 4 SSN: *

If you are a tribal member and doesn't have a SSN, please put N/A. And choose your Tribal benefit below. You will need to enter your Tribal Identification Number (TIN).

DOB: *

Email: *

Phone Number: *

Who is receiving government assistance? *

My-Self
Someone Else in Household

Qualifying Beneficiary Details:

First Name: (Beneficiary) *

Middle Name: Beneficiary

Last Name: (Beneficiary) *

Suffix: (Beneficiary)

Last 4 SSN: (Beneficiary) *

If beneficiary is a tribal member and doesn't have a SSN, please put N/A. And choose their Tribal benefit below. You will need to enter their Tribal Identification Number (TIN).

DOB: (Beneficiary) *

Service Address:

Address Line 1: *

Address Line 2:

City: *

State: *

Zip Code: *

Different mailing address? *

Mailing Address:

Mailing Address Line 1: *

Mailing Address Line 2:

Mailing City: *

Mailing State: *

Mailing Zip Code: *

What is the best way to reach you? *

Calling
Email
Texting

ACP Qualification(s): *

Medicaid
Supplemental Nutrition Assistance Program (SNAP)
Supplemental Security (SSI)
Federal Public Housing Assistance (FPHA)
Bureau of Indian Affairs General Assistance
Tribal Temporary Assistance for Needy Families (Tribal TANF)
Food Distribution Program on Indian Reservations (FDPIR)
Head Start
Eligibility Based on Income (see "ACP" page for income qualifications)
Veterans Pension or Survivors Pension
School Lunch/Breakfast Program
Federal Pell Grant
Existing low income program
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

Check all that apply...

School Name: *

School State: *

School District: *

Tribal Identification Number (TIN) *

Upload Proof(s): *

Click or drag files to this area to upload. You can upload up to 12 files.

Choose Plan: *

ACP Home Internet ($35.99)
ACP Tribal Home Internet ($0.00)
Home Connect ($50.99)
Home Connect Plus ($62.99)
Home Connect Super ($82.99)

All Monthly Plans Prices already include the ACP discount.

Mobile Broadband Device: *

Tablet - Copay - $12.00
BYOD - Sim Kit - $0.00

ACP Home Internet Router: *

Router/Activation - $65.00

How do you want to pay for the Router? *

Pay in Full
PayPal Pay Later
Installment Payments

Home Internet TOP Router: *

Router/Activation - $260.00

For installment payments, please go to TJ Retails Marketplace. On the check out page please choose either Klarna, Affirm or Afterpay as your payment method. After purchasing the router successfully please insert your router order confirmation number in order to complete the plan subscription.

Router Order Confirmation #: *

Is your device unlock? *

Choose Device Network: *

GSM-T (T-Mobile)
GSM-A (AT&T)

Device IMEI Number: *

You may be able to find this information on the about page in the setting section on your device.

Shipping Fee: *

Standard - $15.00

Total

$0.00

Affordable Connectivity Program (ACP) Consent *

I certify that information's provided are truthful and provided willingly & I authorize WaveNetworks and its contracted partners, for the purpose of applying for, determining eligibility, enrolling in and seeking reimbursement of Affordable Connectivity Program (ACP) and by continuing with this application I affirm and understand that the Affordable Connectivity Program (ACP) is an FCC program that reduce monthly plan subscription for a limited time and at the end of agreement I may recertify for the benefit, choose a pay plan or switch to another provider.

Household Agreement *

I know that my household can only get one ACP benefit and, to the best of my knowledge, my household is not getting more than one ACP benefit. I understand that I can only receive one connected device (desktop, laptop, or tablet) through the ACP, even if I switch ACP companies.

Benefit Change Notice *

I understand that I have to tell WaveNetworks within 30 days if I do not qualify for the ACP anymore, including:

1) I, or the person in my household that qualifies, do not qualify through a government program or income anymore. 2) Either I or someone in my household gets more than one ACP benefit.

Address Change *

I agree that if I move I will give WaveNetworks my new address within 30 days.

Privacy Consent *

I agree that any state, local, Tribal government, school or school district, may share information about my receipt of benefits that would establish eligibility for the ACP, and that such information will be used only to determine ACP eligibility.

ACP Transfer Consent *

Where applicable, I consent to transfer my services from my existing ACP provider to WaveNetworks.

ACP Opt-In Consent *

By clicking on the ENROLL button, I acknowledge and confirm that I have read and understand the disclosures above and want to OPT-IN into the ACP discounted broadband program.

Payment Info: *

Card Number

Expiration Date

Security Code

Card Holder Name

To pay with your PayPal account or the "Pay Later" option please select PayPal above.

The last day to apply for the ACP program is February 7 2024 at 10:00PM EST.

To apply you need:

Qualifying Beneficiary Details:

Service Address:

Mailing Address: