Request edit access
Sign in to your Google account to fill out this form
This form contains features which require sign in. Your identity will not be revealed.
Responses cannot be edited
Are you an elected municipal leader interested in community broadband?
Let us know who you are, and who you represent. We will list you in a public roster so others get get in touch with you, as well as following up on how we can help with next steps. Thank you!
What's your name?
What community do you live in?
What's your role in the municipality?
What's your email address?
If you have Twitter, what's your handle?
What's your phone number? (Won't be listed publicly.)
Why are you interested in community broadband? (Check all that apply.)
I want faster Internet for my community.
I want cheaper Internet for my community.
I think municipalities should be involved in Internet infrastructure.
Send me a copy of my responses.
Never submit passwords through Google Forms.
This form was created inside of OpenMedia.
Terms of Service