Community Internet Service Feedback Request Form

Community Internet Service Feedback Request Form
Please share your experience and feedback about your community internet service to help us improve connectivity and support.
Your Full Name
First NameLast Name
Email Address
example@example.com
Phone Number (optional)
Please enter a valid phone number.Format: (000) 000-0000.
Address or Neighborhood
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Which internet service provider do you use?
Type of Internet Connection
Other
How would you rate the following aspects of your internet service?
Rows Excellent Good Average Poor Very Poor
Speed
Reliability
Customer Support
Value for Money
Overall, how satisfied are you with your internet service?
Have you experienced any of the following issues? (Select all that apply)
Other
How likely are you to recommend your current internet service provider to others?

0
1
2
3
4
5
6
7
8
9
10
0 is Not at all likely, 10 is Extremely likely
Please share any additional comments or suggestions to help us improve community internet services.
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