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Apply Here

 

Download Application Form

Application (pdf) Form A (English)

Application (pdf) Form A (Spanish)

Application (pdf) Form B
(English)

 

Please fax completed application along with your ID card and Proof of elibility card for complete processing.

 

Application can be mailed to:

Access Wireless
2 Centerview Drive STE 103 Greensboro, NC 27407

or by Fax: 1-888-808-6524