ACP Application Form

ACP Application Form

For tablets, phone and discounted home internet. These programs are apart of the Affordable Connectivity Program & Lifeline Program. You must be at least 18 to sign up. If you receive SNAP(food stamps), Section 8, Medicaid, School Lunch program, SSI(disability) or Pell Grant you could qualify instantly. You can also qualify via income.
Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
Last 4 digits of your social security number*
Upload a valid picture ID (driver license or state ID)*

Cancelof
Choose Which Benefit Do You Receive*
How Did You Hear About Us? PLEASE include agents name!*
Important please read:

The ACP benefit is a 2 part benefit.

Part 1: is a monthly payment for internet access which is free to you if you qualify. This benefit is good for 1 year and will be accessed annually to confirm you still qualify for each additional year.

Part 2: is a 1 time discount on an android tablet you can use to access the internet, with the free service you receive from part 1.

In some cases you may have to submit documentation to prove you qualify, in that case your agent will alert you and provide a way for you to send documentation electronically.

*It is important to know that every application is deleted within 24 hrs of approval or denial. For service related question you will need to contact the service provider which will be provided in the box with device upon shipment. We only retain names, order number, date activated to protect you, our clients, our company and our partners by deleting all other personal information.

**A one time activation fee MAY BE required for phones and tablets.

***If your tablet/phones needs to be shipped to you, you will be required to pay that fee. It can range from $15-$30 and your agent will let you know. Our agents will meet you in a public location if you are in the Houston, Atlanta or Indianapolis areas.

****Please make sure you use your tablet at least once a month not on wifi to keep it active. You have signed up for the Affordable Connectivity Program (ACP) with Whoop Connect. If you have another provider you will lose that service with them if you sign up with us.

You must renew your service once a year. Log into to Whoopconnect.com to set up your online account. This is very important to do asap. If you run out of data you can buy more right on your Whoop connect account. That's why is important to create an account to keep up with your data and usage. If you have any questions or issues about your tablet or account please reach out to customer service. 1888 200 1076.

If you understand please sign below.
First and Last Name*
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