THANK YOU FOR YOUR INTEREST IN MICTA.

IF YOU ARE REGISTERING AS A RESULT OF THE E-RATE OR HEALTHCARE CONNECT FUND PROGRAMS, PLEASE MAKE SURE YOU CLICK THE APPROPRIATE BOX.

YOU MAY CONTACT THE MICTA OFFICE IF YOU HAVE FURTHER QUESTIONS. 888-964-2227

By following the process below, I certify that all statements are true, and that
my organization is one of the following:

• not-for-profit
• state funded school
• government entity (State, County, City)
• or is designated with the IRS as a 501C3 or a 501C6. 

Please register online using the form below or click here for PDF application