Register as a New Agent

1. Do you currently or have you ever offered any Lifeline services?

2. Preferred employment type?

3. Do you currently have a sales team?

4. Are you part of a master agent team?

5. Do you have a storefront?

6. What states would you like to work in?

7. What ETC's have you distributed for in the past?

8. On average, how many activation's per day do you complete?

9. What is your shirt size?

10. Upload Drivers License

11. Upload File ACH Authorization

Download the PDF ACH Template

12. Upload File W9 - Request for Taxpayer

Download the W9 Template

13. Upload File Compliance Manual