Help us know you better

    How many devices would be connected to the internet?

    1-34-67-10

    How many members of your household work from home or attend online classes?

    1-34-67-10

    How often do you use your internet?

    FairModerateHeavy

    Do you currently have a home internet provider?

    YesNo

    Are you satisfied with your current internet service?

    YesNo

    Are you currently paying any other monthly utility bills?

    What is your preferred method of payment?

    Do you have a valid government issued ID?

    What is your current source of income?

    How associated are you with community Councilor Samuels?