Superfast Broadband for your Community Survey

With your support Superfast Broadband can become a reality in our community. By working together we can make higher bandwidth available to more people at a lower cost.

Superfast broadband brings many economic and social benefits, as well as the potential to provide education, healthcare and interactions with local and central government in innovative and cost-effective ways. To get started we need to know where people live and work that want to access to superfast broadband.

1. Your location

Your location Name of Town, Village, Parish
Postcode

2. Have you ever tried to use the internet at this address?

Have you ever tried to use the internet at this address? Through your telephone line

Through a Cable TV connection like Virgin media

Using a mobile phone

For Work

3. How would you describe your current broadband connection

	Excellent	Average	Poor	N/A (Unavailable)
Speed	*How would you describe your current broadband connection Speed Excellent	Speed Average	Speed Poor	Speed N/A (Unavailable)
Reliability	Reliability Excellent	Reliability Average	Reliability Poor	Reliability N/A (Unavailable)
Cost	Cost Excellent	Cost Average	Cost Poor	Cost N/A (Unavailable)
Range of choice of supplier	Range of choice of supplier Excellent	Range of choice of supplier Average	Range of choice of supplier Poor	Range of choice of supplier N/A (Unavailable)

4. How many users share the connection?

How many users share the connection? 1

5 or more

5. What are the age ranges of the users?

What are the age ranges of the users? Under 18

18-24

25-34

35-54

55-64

65+

6. Speed Test – please run the speed test at http://www.mybroadbandspeed.co.uk and enter the results below. Please be aware of advertisements on these websites that may prompt you to download software and promote 'special offers'. Note that you do not need to download any software to run the broadband speed tests - you just need to click on the option to begin or start the test. WCC is not responsible for the content on external Internet sites. A message is currently displayed on MyBroadbandSpeed.co.uk saying that the site is experiencing technical problems and may display misleading test results. You can continue to use this site but we would suggest running two or three tests to ensure that the results are consistent.

Speed Test – please run the speed test at http://www.mybroadbandspeed.co.uk and enter the results below. Please be aware of advertisements on these websites that may prompt you to download software and promote 'special offers'. Note that you do not need to download any software to run the broadband speed tests - you just need to click on the option to begin or start the test. WCC is not responsible for the content on external Internet sites. A message is currently displayed on MyBroadbandSpeed.co.uk saying that the site is experiencing technical problems and may display misleading test results. You can continue to use this site but we would suggest running two or three tests to ensure that the results are consistent. Download speed

Upload speed

7. What would you like to use faster broadband for?

What would you like to use faster broadband for? Sending emails

Browsing the web

Listening to music

Online shopping

Watching TV and video clips

Downloading films

More than one person doing the activities ticked above

8. If you have any other comments about the Internet connection you have, please tell us below:

If you have any other comments about the Internet connection you have, please tell us below:

9. How soon would you like to upgrade to faster broadband?

How soon would you like to upgrade to faster broadband? Within a year

Over the next 2 years

Over the next 5 years

I’m happy with my current connection

Other (please specify)

10. How much would you be prepared to pay? Answering this question will help suppliers understand the willingness to take up the service where provided and under no circumstances does does it give a commitment to buy.

How much would you be prepared to pay? Answering this question will help suppliers understand the willingness to take up the service where provided and under no circumstances does does it give a commitment to buy. Nothing, do not need it.

Less than £10 per month

£10-20 per month

£21-30 per month

£41-50 per month

More than £50 per month

11. Would you be prepared to make a generic (non-supplier specific) commitment to buy a service if that increased the prospects of investment in broadband?

Would you be prepared to make a generic (non-supplier specific) commitment to buy a service if that increased the prospects of investment in broadband? Yes

12. In areas with insufficient broadband, it is possible to provide a dedicated, high-speed community broadband service. For example, a parish, group or business would fund the initial setup cost, with individual subscribers then paying a monthly subscription. If the business case is strong enough, it is possible that the supplier will cover all set-up costs or grant funding may be available.

In areas with insufficient broadband, it is possible to provide a dedicated, high-speed community broadband service. For example, a parish, group or business would fund the initial setup cost, with individual subscribers then paying a monthly subscription. If the business case is strong enough, it is possible that the supplier will cover all set-up costs or grant funding may be available. I would be interested in getting involved in my area

I would be able to offer sponsorship or other support

I would like further information

13. By providing your contact details you will help us to build a stronger case for superfast broadband in your area.

PLEASE NOTE THAT BY REGISTERING YOUR INTEREST YOU ARE AGREEING THAT THE FOLLOWING INFORMATION (post code, street name, house/flat number & phone number) MAY IN TURN BE SHARED WITH POTENTIAL INTERNET SERVICE PROVIDERS. ALSO ANY SUBSEQUENT SURVEY DATA THAT YOU PROVIDE MAY BE USED, IN AGGREGATED FORM, BY THE CSW BROADBAND PROJECT TEAM TO HELP STIMULATE COMMERCIAL INVESTMENT IN YOUR POSTCODE AREA. TO DO THIS, THE CSW BROADBAND PROJECT TEAM WOULD HAVE TO SHARE THE SURVEY OUTPUT WITH POTENTIAL SUPPLIERS. BY REGISTERING YOUR INTEREST YOU ARE ALSO CONFIRMING YOUR CONSENT TO RECEIVE EMAILS AND OTHER COMMUNICATION FROM THE CSW BROADBAND PROJECT TEAM AND TO BE SURVEYED.

By providing your contact details you will help us to build a stronger case for superfast broadband in your area. PLEASE NOTE THAT BY REGISTERING YOUR INTEREST YOU ARE AGREEING THAT THE FOLLOWING INFORMATION (post code, street name, house/flat number & phone number) MAY IN TURN BE SHARED WITH POTENTIAL INTERNET SERVICE PROVIDERS. ALSO ANY SUBSEQUENT SURVEY DATA THAT YOU PROVIDE MAY BE USED, IN AGGREGATED FORM, BY THE CSW BROADBAND PROJECT TEAM TO HELP STIMULATE COMMERCIAL INVESTMENT IN YOUR POSTCODE AREA. TO DO THIS, THE CSW BROADBAND PROJECT TEAM WOULD HAVE TO SHARE THE SURVEY OUTPUT WITH POTENTIAL SUPPLIERS. BY REGISTERING YOUR INTEREST YOU ARE ALSO CONFIRMING YOUR CONSENT TO RECEIVE EMAILS AND OTHER COMMUNICATION FROM THE CSW BROADBAND PROJECT TEAM AND TO BE SURVEYED. Name:
Address 1:
Address 2:
City/Town:
County:
Post Code:
Email:
Phone:

14. Sharing your information and future contact

Sharing your information and future contact Please tick here if you do not wish to have your personal data shared with internet service providers

Please tick here if you prefer not to be contacted by the CSW Broadband Project Team in the future

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1. Coventry, Solihull and Warwickshire

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Superfast Broadband for your Community
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