Locality Survey | Commonwealth Connect

What is the county or city in which your residence is located?

Do you subscribe to the Internet at home?

Access at home: Yes

What kind of Internet connection do you have at home?

Describe "other" below:

What would you like to be able to do online that you can't with your current home connection (or lack thereof)? (Check all that apply)

	What do you use your home Internet for? (Check all that apply. Business information further down.)
	Work from home (i.e. telework)
	Operate a home-based business
	Online education and training
	Transmit large data files
	Browsing (i.e. looking at websites)
	Email
	Music Streaming (E.G. iHeart Radio, Spotify)
	News
	Online Shopping
	Financial/banking transactions\|
	Search for work
	Social Media (e.g. Facebook, Twitter)
	Healthcare communications/monitoring (i.e. telehealth)
	Video & Phone calls via the Internet (e.g. Skype)
	Video Games
	Video Streaming (e.g. Netflix, YouTube)
	Other

Please rate your home Internet service:

What is the primary reason your home Internet service does NOT meet your needs?

Please describe "other" below:

Access at home: No

What is the main reason you do not have Internet access?

Describe "other" below:

Select an option that best describes both your household size (including yourself) and household income*.

*TOTAL HOUSEHOLD INCOME IS DEFINED AS INCOME ALL HOUSEHOLD MEMBERS OVER THE AGE OF 17 RECEIVE FROM ALL SOURCES, SUCH AS WAGES, SALARIES, INTEREST INCOME, INVESTMENT INCOME, SOCIAL SECURITY, PUBLIC ASSISTANCE, OR OTHER SOURCES.

Please describe "other" below:

If an affordable, faster Internet option were offered to your household, would you be willing to commit to a year-long contract to take that service?

How much would you be willing to spend for faster Internet service?

Describe "other" below:

What kind of phone service do you rely on most at home?

Please describe "other" below:

Is your home phone service consistently reliable?

Are there any children in K-12 living at this home address, including home schooled?

Where do(es) your child(ren) access the Internet most often after-school?

Describe "other" below:

Do you own a business within the same county or city as your home address?

Business Internet Information

Address

Address 2

City/Town

ZIP/Postal Code

How does this business connect to the Internet?

Describe "other" below:

How important is the Internet to your business operations?

Please rate your business Internet service:

Describe "other" below:

Does your business internet service meet your needs?

What is the primary reason your business Internet service does NOT meet your needs?

Describe "other" below:

If an affordable, faster Internet option were offered to your business, would you be willing to commit to a year-long contract to take that service?

How much would you be willing to spend for faster Internet service for your business?

What kind of phone service does your business rely on most?

Describe "other" below:

Is your business phone service consistently reliable?

General Comments