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Sign Up Today!

Call 1.866.966.2628 toll free to speak to an American Assistance representative who can help you through the application process.*

 

Click here

Click here to fill out an online application.

 

Download an application

Download an application

 

Other Applications and Forms:

Multiple Head of Household Application 
TLS Opt Out Request

 


Please fax your application to 1.877.211.3705.
Or mail your signed application to:
American Assistance
PO Box 577
Toledo, OH 43697

 

*Offers may vary by State.