Printable Safelink Application

The printable Safelink application can be printed from any standard inkjet or laser jet printer, and can be mailed or faxed for review. This application is for review for the Safelink Wireless government assistance plan which can get a qualified recipient up to 250 anytime minutes, a free cell phone, and a texting plan. These plans are subject to federal and state regulations.

Use the link below to download or print the Safelink application to get see if you are eligible for the free Safelink Wireless cell phone. The links below will include the link to to the  printable application along with a link to the online application for your convenience.

Printable Safelink Application  This will direct you to the downloadable and printable PDF version of the application.
Online Safe Link Application This link will direct you to the page with link to the online version.

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16 Responses to Printable Safelink Application

  1. janet on October 28, 2011 at 5:35 pm

    Need an application to take to someone else to fill out

    • claudia cox on March 22, 2012 at 1:38 pm

      need printable application for mississippi

    • Timothy Cousino on March 28, 2012 at 4:36 pm

      Can I print off or receive an application
      to give to a friend of mine.

    • charles walker on March 29, 2012 at 12:07 am

      need application

  2. Glenn Brown on January 24, 2012 at 2:15 am


    • Sandy Emhoff on September 19, 2012 at 12:22 am

      No, he has his old phone, just need minutes added to this. I had signed up for the 250 minute a month plan. He does not have a credit card or any means to add minutes each month, so the 250 minutes were great for his needs.

  3. Anthony L. Cox Sr. on April 23, 2012 at 2:49 pm

    I already have application and would like to keep the 120 minutes roll over package.

    I have the application but would like to complete application on line for faster processing. How would I do this? I cannot find application to complete and forward on line.

    Renewing application. PROMO CODE RUSH 30 – DEADLINE MAY 5, 2012

  4. melvin ford on June 18, 2012 at 6:21 pm

    I need a phone

  5. YESENIA on July 10, 2012 at 9:12 pm


  6. gene bonn on July 13, 2012 at 2:00 am

    i need it becase of my health

  7. gene bonn on July 13, 2012 at 2:02 am

    i do need becase of health

  8. gene bonn on July 13, 2012 at 2:03 am

    i do need becase of my health

  9. lYNN WALSH on August 24, 2012 at 6:08 pm

    need printable application for someone else

  10. lYNN WALSH on August 24, 2012 at 6:09 pm

    I need a printable application for someone else

  11. kathi sands on August 28, 2012 at 12:59 pm

    need printable application

  12. Sandy Emhoff on September 19, 2012 at 12:20 am

    I applied for a Safelink phone for my brother, Theodore J. Baxter last week and did not receive the fax application I was told I would receive. He has relocated to Florida and I was told I needed to reapply for him. He is mentally handicapped and legally blind. He needs his phone as soon as possible. I would like to keep his old number which is 860-710-1895. I am reapplying again, so please contact me as soon as possible when he can get this phone recharged with the 250 minute plan. It is very important for him to get this phone working because he needs to keep in touch with our mother. Thank you. Sandra L. Emhoff, (POA), sister