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1. Please describe your current voice and data service:
Number of Phone Lines:
  Type of Data Connection:
  What speed is your current connection?
2. How much do you currently spend per month on Telephone & Internet Services?
$ per month
3. Are you interested in Fiber based services for your home or business?
4. What would you pay for the same speed Internet service on Fiber?
5. What would you pay for faster speed Internet service on Fiber?
6. Would faster Internet speeds improve your current or future home or business opportunities?
7. Would you change your service to a Fiber Network if it was available to your home or business?
  If No or Unsure, please tell us why?
 
8. Who are your current service providers?
Voice:
  Data/Internet:
  Phone System:
9. Is there anything you wish you could change about your current Telephone/Internet Service?
 
10. Do you have multiple choices for Voice/Data providers in your area?
11. Who are the current provider choices for Voice/Data in your area?
Copper (Telephone/DSL/T-1):
  Coax (Cable/Broadband):
  Fiber:
12. Are you presently on a contract?
13. What term/length of contract would you sign to get Fiber based services?
14. Please provide any other comments or questions you would like answered
 
15. Please Enter your Home or Business Contact Information
Business Name
if applicable:
  Contact Name:
  Address:
  City
  State MN
  Zip
  Phone:
  E-mail: