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Community Residential Broadband Survey

  1. Please provide your full home address. (Follow the examples exactly. No PO Box numbers. This is only used to identify demand for broadband services.)
  2. Is this location
  3. Do you have internet access at home?
  4. How important is Internet access to you or your household?
  5. What is the speed of your internet connection?
  6. Does or did high speed, affordable internet access influence where you chose to live?
  7. For your household, how much do you spend each month for local and long distance telephone , TV, and/or Internet? Do NOT include cell phones unless that is your primary source for internet in the home.
  8. How much do you pay now for at home Internet access each month?
  9. What would you be willing to pay for a faster, higher quality Internet connection?
  10. What type of Internet do you have at home?
  11. Based on the type of Internet connection you selected above, why do you still have it? (select all that apply)
  12. Are there any children of school age K-12 living at this address?
  13. Is anyone in your household taking college or job training courses online?
  14. How many devices (for example computers, cellphones, smart TVs) connect to the Internet in you household?
  15. What do you most often use the Internet for? Check all that apply
  16. What would you like to be able to do online that you can't with your current connection? (Check all that apply)
  17. Does anyone in your household use the Internet to work from home (i.e. telework or telecommute)?
  18. Select the items you agree with:
  19. Does anyone in your home operate a home based business?
  20. Do you own a business?
  21. Leave This Blank:

  22. This field is not part of the form submission.