Note: Funding requests with more than 100 Billing Account Numbers must download this certification form. You must complete the form and upload it below for processing.

* Indicates required field
Applicant Information
Contact Information
Billing Accounts Associated with Funding Request
E-Rate Growth / Additional Services. This section is for customers with new pending service requests.
Electronic Signature
By checking the box above, the applicant assumes full responsibility for the accuracy of the information provided in this certification form process and authorizes Frontier to set up Service Provider Invoicing (SPI) for the account number(s) listed on the second step of this certification form process. The applicant also agrees to hold Frontier harmless in the event of any claim or liability arising out of, or resulting from, any inaccurate information provided by the applicant.