Affordable Connectivity Program Consent Form

Filling out this consent form is one of the last steps that must be completed before your Affordable Connectivity Program (ACP) discount can be applied to your CCG Home Fiber bill.

If you have not already applied online and verified your ACP eligibility with the FCC, you must complete that step before filling out the consent form below. Visit the ACP website for more information.

You must also sign up for CCG Home Fiber service using our online signup form before completing the consent form below.

By completing and submitting the Affordable Connectivity Program Consent Form you are agreeing that:

  • You have received disclosures on the ACP program.
  • Your ACP benefit can be applied directly to your CCG Fiber monthly bill.
  • Information provided to CCG can be transmitted into NLAD to verify eligibility in the Affordable Connectivity Program.
  • If your ACP eligibility changes and you can no longer participate in the program you will notify CCG immediately.
  • If you are no longer eligible for the program your monthly rate will return to $69.99 for internet service.

If you have received your ACP Qualifying number from the FCC and have signed up for CCG Home Fiber service, please fill out this information: