Red Bolt Broadband Interest Survey

Red Bolt Broadband Interest Survey

Continental Divide, an energy and telecommunications cooperative, plans to apply for state and federal grants to extend its Red Bolt Broadband service to your area. If you are interested in receiving our broadband service, please answer the questions below.
Resident or Business Name*
Owner Name*
Phone Number*
Physical Address*
Email Address*
example@example.com
Mailing Address*
1. Are you interested in receiving service from Red Bolt Broadband?*

YesNo
2. Are you a resident, farm, or other business customer?*

ResidentFarmBusiness
3. What communications services are you currently using?*

InternetVideo/TVLandline PhoneCell PhoneOther
4. How much do you pay for each of the following? a. Internet: *
b. Landline Phone:*
c. Video/TV:*
d. Cell phone:*
e. Other:
5. What is the speed you receive from your current internet provider?*

NoneLess than 10 Mbps10 To 25 Mbps25 to 100 Mbps100 or more MbpsI don't know.
6. What internet speed would meet your needs?*

NoneLess than 10 Mbps10 To 25 Mbps25 to 100 Mbps100 or more MbpsI don't know.
7. How would you like us to let notify you when service is available to you?*

EmailPhoneMail
This form is not a binding commitment to provide telecommunication services. This information will be used internally by Continental Divide for marketing and financial planning purposes. The information may be shared wholly or in part with public and private entities for the purposes of securing funding for telecommunications infrastructure construction and/or services.
Should be Empty: