Sign Up Today!

Call 1.866.266.7212 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


To keep the free phone you received in 2013 OR 2014 you MUST recertify by the end of 2015! Click here to fill out the recertification form.

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.