New Lebanon Broadband

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* 1. What is your last name?

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* 2. What is your first name?

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* 3. What is your street address (NOT P.O. Box)?

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* 4. What is your ZIP code?

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* 5. What is your preferred method of contact?

Email Address

Phone Number

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* 6. Who is your Internet Service Provider?

Consolidated Communications

Charter Spectrum

Other (please specify)

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* 7. What Internet connection speed did you order (or desire)? Please enter the nearest whole number with no decimal points, etc.

Mbps Down

Mbps UP

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* 8. Perform the speed test per instructions on the Town website. Record your result. Round off to the nearest whole number, with no decimal points, etc.

Mbps Down

Mbps Up

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* 9. Provide any other information pertaining to your problem.