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Step 1 | Personal Information for the Applicant (person requesting the Frontier account)
Step 2 | Eligibility
Please provide proof of participation by uploading a copy of benefit statement, notice, letter or other official participation document. The documentation must include the name of the person participating in the qualifying program, address (must match address where Frontier service is requested) and program effective date.
Complete this section if the proof documents are not in the applicant's name
Step 3 | Confirmation & Signature
Step 4 | Submit Application & Proof Documents

Confirm all required information has been filled in completely and a copy of supporting documents for the program you checked in Step 2 is included prior to submitting the application. You must provide proof of your program participation by uploading a copy of a benefit statement, notice letter of participation in a qualifying program, program participation documents, or other official participation document for the program you checked in Step 2.

If your program proof is not in your name, you MUST complete the special certification box located directly below the file upload section. Be sure to check both boxes beneath the words “I certify the person named below …” and then fill in the name, date of birth, and last 4 digits of the social security number (or Tribal ID number) for the person whose name is on the proof document.

By submitting this form, I certify under penalty of perjury:
  • The information contained in this application and accompanied documents are true and correct to the best of my knowledge.
  • The low-income Frontier broadband internet access service for which I am applying will be billed in my name.
  • The address listed is my primary residence and not a second home or business.
  • I acknowledge that my household can only receive one low-income broadband internet access service in total, even if my household has more than one internet account.
  • I authorize Frontier Communications to confirm my continued eligibility for this low-income program.
  • I am aware that Frontier requires an approval (or recertification) process every two years to ensure continued eligibility for this program, and I may be discontinued from the program if I fail to recertify.
  • I authorize state and/or federal agencies to discuss with and/or provide Frontier information verifying my participation in benefit programs that qualify me for this program.
  • I agree to notify Frontier when I no longer participate in any of the qualifying public assistance programs.
  • I have provided documentation of proof of eligibility along with this application.
  • By submitting this form, I acknowledge that providing fraudulent documentation to receive assistance is punishable by law.