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Apply for Lifeline Service

Ready to get started? Complete the form below to begin your application. Haven't checked your eligibility yet? Check eligibility first.

Before You Apply

Have the following ready to make your application faster:

Proof of program participation (such as a SNAP or Medicaid award letter), or recent income documentation
A government-issued photo ID
Your Social Security Number or Tribal ID number
Your current mailing address

Applying does not guarantee approval. Final eligibility is determined through the National Verifier and/or your state Lifeline administrator.

Prefer to Apply by Phone?

Call +1 (206) 335-7156 to apply with the help of a support representative.

Start Your Application

First Name

Last Name

Date of Birth

Home Address

State

Email Address

Phone Number

How do you qualify?

Program participation (SNAP, Medicaid, SSI, etc.) Income-based eligibility

This is a demonstration application form. It does not currently submit data to a live backend or the National Verifier. A production integration would be required before accepting real applications.