Agreement for Service
You are only allowed to get one Lifeline benefit per household, not per person. Your household cannot get Lifeline from more than one company. You must give accurate and true information on this form and on all Lifeline-related forms or questionnaires. Lifeline is non-transferable. Please see the complete Lifeline Program Rules.
By signing below I agree to have Arvig internet service installed and provided to my home under the Affordable Connectivity Program. It is my responsibility to cancel service if the program ends. If I don't cancel service, I understand that I am responsible for the monthly bill.