Reconnect Rural USDA Program
Help Us Grow Our Community!
Name
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Age
How Many People in Household?
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How Many Children in Household?
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How Many Students in Household?
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Income Level
How Many Computers in Household?
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How Many Phones in House That Use Wifi?
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How Many Tablets/iPads in House?
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How Often Are You Online?
Existing Service Provider
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Types of Service in House
Satisfaction With Current Provider
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Completely Satisfied
Interest in Switching Providers
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What is Your Current Internet Speed?
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What Type Of Service Are you Interested In?
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