Affordable Connectivity Program (ACP)
Enrollment Form

As an approved ACP service provider, Point Broadband makes signing up easy. Complete the form below and your credit will be applied upon enrollment verification. Please allow up to 30 business days for confirmation. The information that you enter into this form must be an exact match with the information entered on your government form.

First Name:
Middle Name:
Last Name:
Phone Number:
Street Address:
Zip Code:
ACP Application ID#:
Date of Birth:
Last 4 of Social Security #:
I acknowledge I have received and reviewed disclosure information about the Affordable Connectivity Program (ACP). I affirmatively consent with this submission to my enrollment in the ACP, to submission of my information to NLAD, and to the application of the ACP benefit to the broadband service offered to me by Point Broadband.