Form online 2026

1. Click ‘Get Form’ to open the Lifeline Program Application Form in our editor.
2. Begin by filling out your personal information in Section 2a. Provide your full legal name, phone number, date of birth, email address, and the last four digits of your Social Security Number (SSN). Ensure you use capital letters and black ink.
3. Continue to Section 2b to provide your home address. If applicable, indicate if you live on Tribal lands and fill out your mailing address if it differs from your home address.
4. In Section 3, indicate how you qualify for Lifeline by checking the appropriate government assistance programs or providing income details. Attach any necessary documentation to support your application.
5. Review Section 4 carefully and initial each agreement statement to confirm your understanding and compliance with the program rules.
6. Finally, sign and date the form before submitting it through our platform for processing.

Start filling out your Lifeline Program Application Form online today for free!