1.Are you satisfied with the reliability of your current internet? 

Yes

No

2.How satisfied are you with the speed of your current internet?

Not satisfied at all

Somewhat satisfied

Satisfied

Very satisfied

Extremely satisfied

3.Do you agree that you receive good value for the money you pay for your current internet service? 

Strongly disagree

Disagree

Neither disagree nor agree

Agree

Strongly agree

4.Would you like more information about new options for high-speed internet in your community? 

Yes

No

5.Name (optional)

6.Email (optional)

7.Address (optional)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone Number