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(Please do not forget to SIGN the application in Section 4.) The information below MUST be that of the person applying for Assurance Wireless service. Fill Assurance Wireless Application Pdf, Edit online. Sign, fax and printable from PC, iPad, tablet or mobile with PDFfiller ✓ Instantly. Try Now! The Assurance Wireless application, can be downloaded from the website filled out and mailed or faxed to the company. The application has new questions. B PROGRAM-BASED ELIGIBILITY. Fill in bubbles for all programs that you or a household member are currently enrolled in. You must provide proof of program  I'm an Assurance Wireless field agent. A customer service representative told me I could download a paper application for a customer but I don't see a link for  The Assurance Wireless Application a simple form that may literally take you all Failure to verify eligibility will result in termination of Assurance Wireless service. This computer will not let me download, please email me this information to 

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