Lifeline Agent Application

THIS OFFERING IS A FEDERAL LIFELINE SUPPORTED SERVICE provided by Assist Wireless, LLC. Lifeline is a government assistance program that provides discounts on your monthly phone and/or broadband/Internet service. Only eligible consumers may enroll. Eligibility is based on income or participation in certain government benefit programs and is determined by the National Verifier (documentation may be required). The Lifeline benefit is non-transferable and is limited to one monthly discount per household for either wireless or wireline service. For Lifeline eligibility criteria and applicable terms and conditions, visit https://www.assistwireless.com/terms-and-conditions/. OFFER DEPENDENT ON LIFELINE ELIGIBILITY. If it is determined that you are not eligible for Lifeline services and/or you do not reside on eligible Tribal lands, you will not be eligible for this offer or any variation of it. FREE PHONE OFFER with qualifying NEW Tribal Lifeline enrollment only. Offer not available for existing Assist Wireless customers. WHILE SUPPLIES LAST. Only one offer may be redeemed per customer. Rain checks are not available. Substitutions may be offered at the sole discretion of location management if original offering is out of stock and unavailable. Offer ends at the discretion of management or when offer supplies and substitution device supplies are exhausted at each participating Assist Wireless location. OFFERS MAY VARY BY LOCATION and service may not be available in all areas. SERVICE PLAN TAXES AND FEES included with service plan pricing. EMERGENCY SERVICES. Coverage limitations of wireless mobile phone service may affect access to E-911 and/or 911 in the event of an emergency. Wireless service may also experience interruptions due to weather conditions, terrain, or gaps in service coverage. If you remove your Assist Wireless handset from your home, other family members in your household may not be able to reach 911 emergency services. SERVICES AND DEVICE OFFERS subject to Terms and Conditions and Agreement to Arbitrate Disputes and Judge or Jury Trial Waiver available at https://www.assistwireless.com/terms-and-conditions/. Service plan details are available at: https://www.assistwireless.com/lifeline-plans/. UNLIMITED DOES NOT MEAN UNREASONABLE USE. Terms and conditions specific to acceptable use policies and plans include unlimited talk and text. Please review this detail prior to enrollment.