Affordable Connectivity Program

Your Information

Enter your name and address EXACTLY as they appear on the "Qualified" screen of the National Verifier application. Failure to do so will result in your application being rejected and the discount will not be applied to your Brightspeed account.

First Name*

! First Name is required.

Middle Name

! Please enter a valid Middle Name.

Last Name*

! Last Name is required.

ACP Application ID, or Lifeline Subscriber ID*

ACP Application ID example: Q12345-12345.
Lifeline Application ID example: US4Y54WU5

! EBBP Application ID / Lifeline Subscriber ID is required.

Street Address*

! Street Address is required.

Apt, Unit, etc

City*

! City is required.

State*

! State is required.

Zip Code*

! Zip Code is required.

Please enter Account Number OR Username to submit form.

Example: 401302303 or 303-123-4567 890 or 303 123-4567 or PPB02347768

! Please enter a valid Account Number.

Username*

! Please enter a valid Username.

Last 4 SSN or Tribal ID Number

Enter the last 4 of the SSN or your complete Tribal ID number which was used to qualify with National Verifier "Qualified" screen. If you used an alternate form of identification in your application, input four zeroes "0000".

! Please enter numbers only.

Date of Birth*

Example: MM/DD/YYYY

! Date of Birth is required.

Email Address*

! Email Address is required.

Telephone Number*

(123) 456-7890

Example: 1234567890 or 303-123-4567

! Telephone Number is required.

Oops! Please complete the fields below.

Oops!
Please complete the fields below.

Do you qualify for Lifeline or the Affordable Connectivity Program through your child or a dependent?

If you do not qualify on your own, you can sign up for the Lifeline or the Affordable Connectivity Program through your child or dependent if they participate in any of the qualifying programs.

No, I qualify by myself.

Yes, I qualify through my child or dependent.

Your Child or Dependent's Information

Enter your child or dependent's name EXACTLY as it was entered into your ACP application with National Verifier. Failure to do so will result in your application being rejected and the discount will not be applied to your Brightspeed account.

First Name*

! First Name is required.

Middle Name

! Please enter a valid Middle Name.

Last Name*

! Last Name is required.

Last 4 Digits of your Child or Dependent's SSN or Tribal ID Number

! Please enter numbers only.

Date of Birth*

Example: MM/DD/YYYY

! Date of Birth is required.

Do you reside in a federally designated tribal area?

Yes

Enrollment Disclosures. The Affordable Connectivity Program (ACP) is a benefit program overseen by the Federal Communications Commission (FCC) that reduces your bill for broadband internet access service while you are enrolled in the program.

You may obtain broadband service supported by the Affordable Connectivity Program from any participating provider of your choosing, and you may transfer your benefit to another provider at any time. However, you may only receive one monthly ACP benefit per household regardless of provider, and only one ACP benefit per account. You may apply the ACP benefit to any of Brightspeed's broadband service offerings on the same terms available to households that are not eligible for the Affordable Connectivity Program.

You are not required to sign up for ACP-supported service to obtain or continue to obtain Lifeline-supported services. Qualifying consumers can participate in both the ACP and the Lifeline program, and they may apply the ACP and Lifeline benefits to the same service or to different qualifying services. To sign up for, renew, upgrade, or modify Lifeline services with Brightspeed, please visit: Consumer assistance programs.

If the total monthly charges for your ACP-supported service after the ACP benefit is applied are $0, you must use your ACP-supported service at least once every 30 days. If you don't use your service within 45 consecutive days, Brightspeed may be required to take action including de-enrolling your account from ACP, removing the monthly benefit from your account, and charging the standard monthly rate for the plan in effect at that time.

Brightspeed may disconnect your ACP-supported broadband internet service after 90 consecutive days of non-payment.

If you transfer your ACP benefit from Brightspeed to another provider, but continue to receive service from Brightspeed, or if you are de-enrolled from the Affordable Connectivity Program, you will be subject to the undiscounted rates and general terms and conditions for the Brightspeed service you are receiving.

If the Affordable Connectivity Program ends while you are enrolled, your service will be subject to the generally applicable rates, terms, and conditions for your service. Alternatively, you may choose to stop receiving that broadband internet access service.

You may contact Brightspeed customer centers, as applicable, for help with ACP questions. If you have a complaint about your ACP service, you may file it via the FCC's Consumer Complaint Center.

Please apply the ACP discount to my Brightspeed Internet access plan.I have been provided enrollment disclosures and, after receiving these disclosures, consent to having my ACP discount applied to Brightspeed Broadband Internet service.

Transferring the ACP Discount to Brightspeed from another provider.

If you are transferring your ACP benefit from another service provider to Brightspeed, the effect of the transfer will be that the ACP benefit will be applied to the Brightspeed service, not the service retained from your previous provider. You are limited to one ACP transfer each service month, with limited exceptions. If you choose to maintain service from your previous service provider, your previous service provider may charge you their undiscounted rates for that internet service.

Please transfer my ACP discount from my current provider's service to my Brightspeed Internet access plan. I have been provided disclosures about transferring my ACP benefit and, after receiving these disclosures, I consent to transferring my ACP discount from my current provider's service to Brightspeed Broadband Internet service.

- Or -

I am not transferring an ACP discount to Brightspeed from another broadband provider.

Consent to Transmit Information to the Affordable Connectivity Program Administrator.

To enroll you in the Affordable Connectivity Program, we must transmit the following information about your enrollment to the administrator of the Program, the Universal Service Administrative Company (USAC) to ensure the proper administration of the program. If you consent to us transmitting this information, please indicate so by checking below. If you do not consent, we will not be able to enroll you in the program and you will not receive the benefit.

I consent to having my full name, full address, date of birth, last four digits of my Social Security Number (if applicable), and telephone number, or if applicable, my minor child's or dependent's full name, full address, date of birth, last four digits of their Social Security Number shared with the benefit Program administrator, the Universal Service Administration Company (USAC).

How does Brightspeed protect my information?
Read the Brightspeed Privacy Notice

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