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.