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* 1. About you

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. What is the device you use most often to connect to the Internet?

Desktop computer

Laptop

Tablet

Smart Phone

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* 3. What is the make and model of this primary device? (ex. Samsung S3, iPhone7, etc.)

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* 4. What is the device you use second most often? (ex. desktop, laptop, tablet, smart phone)

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* 5. What is the make and model of this secondary device? (MacBook Air, Dell desktop, iPhone, etc.)

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* 6. What is the primary way you connect to the Internet?

Broadband at home (cable, DSL, etc.)

Phone plan with data

Public wi-fi

Public computer center

Other (please specify)

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* 7. What is the secondary way you connect to the Internet?

Broadband at home (cable, DSL, etc.)

Phone plan with data

Public wi-fi

Public computer center

Other (please specify)