Thank you for your interest in Reconnect’s hardware programs. Please fill out the form to submit your hardware request. Primary Contact Name* First Last Primary Contact Email* Primary Contact Phone*Facility Name* Are you interested in Reconnect's phone lease program?* Yes No HiddenAre you interested in ReconnectBands?* Yes No Shipping Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Reconnect Phone Lease ProgramWhich phone plan would you like?* Plan A: Reconnect Only Mode: The phone will only run the Reconnect Community app. No calls, texts, apps, or web access are allowed. Plan B: Reconnect Select Mode: Device has call & text functionality, internet access, and allows other apps to be installed. Jurisdiction has full control over installed apps, and calls can be limited to specific numbers if desired. How many phones would you like?*Pausing Phone Plans Phones can either be shipped with active or inactive (paused) phone plans. Plans should be paused when phones are not in use for extended periods of time. Please note, there is a monthly fee for paused devices. How many phones should have an active phone plan?*Active plans are billed based on when they are sent, not when they are given to a client.How many phones should have inactive/paused plans?*Paused plans include a $5 per month fee. You must reach out to Reconnect to activate a paused device before using it.Our default service provider is Verizon. Would that be a problem in your area?* Yes No Please explain why Verizon would not work for your program/participants.*Should participants be able to make and receive phone calls?* Yes No Which phones numbers, if any, would you like to whitelist for inbound/outbound calls?These will be the only phone numbers a participant can call or receive calls from on the device. Please include area codes.Should participants be able to make and receive text messages?* Yes No Which apps would you like your participants to have access to on these devices?* Zoom In the Rooms Pexip Indeed Google Maps Web browser Clock Lyft Uber None of the above Other What other apps would you like to be available? A per-device fee will be invoiced upon receipt of your order. Lost, damaged, or unreturned devices are subject to fees. Please refer to the Cell Phone Lease Program Policy for complete terms. For more information on Reconnect's phone lease program, please reach out to support@reconnect.io.Agree?* I understand