Broadband Infrastructure Questionnaire

Broadband infrastructure refers to the networks of deployed telecommunications equipment and technologies necessary to provide high-speed internet access and other advanced telecommunications services to end users.

This questionnaire will take 5 minutes to complete.




Please provide your mailing address (Mention incentive here, if applicable).






Type of property:

Home
Business
Community/Public Building

Please provide your email address, so that we may follow up with additional information or questions if needed.

Can we share your property address with broadband providers? This will help build a stronger case for broadband in your community.

Yes
No

Please describe your existing internet access:

I have internet service at home, excluding cellular phone or hotspot
I have only cellular internet or hotspot at home
I do not have internet service at home

How many working computers, tablets and/or iPads do you have at this location?

How many smart phones do you have at this location?

How many devices other than tablets, laptops, or smart phones (TVs, gaming consoles, smart home, medical) need to connect to the Internet?

Who is your primary Internet provider? (select all that apply)

Internet Service Provider name
Internet Service Provider name
Internet Service Provider name, etc.

Do you sometimes have to use your cellular data plan or another provider when your primary Internet connection is not working?

Yes
No

What cellular data plan do you rely on when your internet is now working? (i.e. Verizon)

To the best of your knowledge, what download speed does your Internet service provider promise you?

Less than 10 Mbps
Between 10 and 25 Mbps
Between 26 and 50 Mbps
Between 51 and 100 Mbps
Between 101 Mbps and 1 Gbps
I don't know

Please describe your level of satisfaction for the following internet service items.

Extremely dissatisfied Somewhat dissatisfied Neither satisfied nor dissatisfied Somewhat satisfied Extremely satisfied
Affordability
Speed
Reliability

Tell us your broadband story:

Please take a speedtest at https://www.speedtest.net/, please report the following results:



Does at least one member of the household (select all that apply):

Operate a home business
Work at home, full or part time
Attend school online, full or part time

(if select no internet) Please tell us why you do not have fixed internet access at your home (select all that apply):

Do not need or want
No services are offered at my location
Price is too high
Provider internet speeds are too low
Service reliability
Other: _____________

What is the maximum monthly price you would be willing to pay for 100 Mbps (high speed upload and download) service?

Less than $25
$26-$50
$51-$75
$76-100
$101+
I don't know
I would not subscribe

If you had internet access at this location, would you use it for (select all that apply):

Access government information
Cloud-based services (Dropbox, iCloud, etc.)
Communication (emails, video calls, social media)
Education (K-12, higher education)
Entertainment (video/music streaming; gaming)
Healthcare information and services
Operate a home-based business
Smart devices / surveillance / security
Telecommute / Remote work
Other: ____________

In your opinion, are there sufficient internet service provider choices at your location? (choose one)

Yes
No