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* 1. What is the name of your community?
(Please use the name of the Municipality in which you reside and receive a tax bill from or First Nation Community)

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* 2. Please indicate the most appropriate description for your location:

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* 3. Have you/will you conduct a speed test through the CIRA/Connectednorth.ca partnership speed test portal?
(Click this link to take the speed test).

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* 4. If you receive high-speed internet, what type of connection do you have?
(If you are not certain what type of internet you have, click here to learn more about the different types of internet delivery)

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* 5. What level of internet service are you currently receiving with your internet package?
(Please choose the closest to yours)

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* 6. Please specify what type of online activities your household, business, or public institution engages in:

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* 7. Please indicate the accuracy of the following statement as it applies to you:

"My current internet connection meets my online activity requirements."

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* 8. Do you feel like your current internet connection limits your ability to participate in the digital economy? 
(For example, the ability to shop online, conduct business, ability to work remotely)

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* 9. The CRTC set a decision that the minimum standard requirement for fixed high-speed internet access for every Canadian household should be 50/10 Mbps with no data usage restrictions. However, just as important is access to high-speed internet is the ability to afford such a service.

When considering a potential subscription to a 50/10 Mbps unlimited data usage service, how important of a factor is affordability?

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* 10. Are you currently able to subscribe to 50/10 Mbps fixed high-speed internet with an unlimited data plan but choose not to subscribe? If so, what are the most important factors in your decision?

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* 11. If you currently are not able to access 50/10 Mbps fixed high-speed internet with unlimited data usage but it were made available to you in the future, which statement would best represent your attitude towards internet cost:

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* 12. Additional comments or questions:
(Please provide your contact information if you wish to receive a follow-up response)

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