Broadband Inquiry Form

The recently signed American Recovery & Reinvestment Act contains $7.2 billion to bring broadband to under-served communities like ours. Let Clayton and the telecom industry know that Clayton needs broadband! Your information will be added to responses from others to help define the network needs of our area.

All fields with an asterisk (*) MUST be completed

*First Name
*Last Name
*Business Name
  
*Service Address
(address/location of current telecommunications services)
*Service Address City
*Service Address State
*Service Address ZIP Code
  
Mailing Address (if different)
City (if different)     
State (if different)
ZIP Code (if different)
  
If your service address is a Rural Route Address, P. O. Box, or other non-911-style address, please provide directions from the nearest major landmark.
   
*Service Phone Number    
Contact Phone Number    
Email Address
   
Do you already have Internet service at this location? If so, what kind of service do you have at present?
I don't have any Internet service at this time.
Dial-up
DSL
Cable Modem
Fixed Wireless
Satellite
Frame Relay
If data T1, how many?  
If Fiber, how much?        Mbps
Other Internet
   
Current Broadband/Internet Cost?     
Current Broadband/Internet Provider 
Is this service for your home, or for your business? Home     Business
   
Do you have any other special needs, or are there other Internet-related services in which you are interested?
I am interested in Web site hosting.
I am interested in eCommerce (selling my goods or services online).
I use my connection to send or receive large files (large graphics, blueprints, professional audio or video)
I am interested in VOIP (Voice-Over-IP, using my Internet connection to supplement or replace traditional phone service)
I am interested in server co-location or dedicated hosting.
I require service to locations outside of Clayton
I have Special Security issues
 
Are you interested in a broadband internet access service that costs $29.95 and a telephone service that costs $24.95 for unlimited calls within the US and Canada? Yes, I'm interested.     No, thank you.