Broadband Inquiry Form

Door County Economic Development Corporation – in our continuing efforts to improve telecommunications infrastructure on the Peninsula – is trying to quickly gauge the current services being used by our local business community and, more importantly, what our future telecommunications needs will be. The recently signed American Recovery & Reinvestment Act contains $7.2 billion to bring broadband to under-served communities like ours. Let Washington, Madison and the telecom industry know that Door County needs broadband! Your information will be added to responses from others to help define the network needs of our area.

If you have any questions about our Door County Broadband Inquiry please email Sam Perlman: sam@doorcountybusiness.com

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 Door County
I have Special Security issues
 
What are your current bandwidth needs?   Options?


What do you anticipate your bandwidth needs to be in three years? In five years?


Are there any other special services you may need, or any other details relevant to your request? If so, please enter them here.