Skip to form
GreenLight-Logo-Update-2021_CMYK_PNG (1)

NYS Affordable Broadband Act Form

To request that Greenlight Networks review your eligibility, you must complete the following form to its fullest. As part of completing the form, you will be required to select the program under which you are eligible from the list below and you will be required to submit documentation proving your eligibility. 

Today's Date*
//
Please select one of the qualifying programs:*
Please Note: The senior citizen rent increase exemption and disability rent increase exemption are only available in NYC, Nassau and Westchester Counties.
Please select the proof of enrollment you will provide.*
Please upload your proof of eligibility.