Wireless Internet Access Site Survey Request

This is the first step in getting North Boone Broadband's Wireless Internet Access Service. After you fill out this form, a North Boone Broadband representative will visit your location to perform a site survey. The site survey is required to determine if the signal from one of our broadcast locations is of sufficient strength and quality. The site survey is free and there is no obligation to accept the service. You can also request a site survey by calling North Boone Broadband at 815-765-9009.

Name:
Address:
Business Name: (if applicable)
City/Area:		Zip Code:
Home Phone:		Work Phone:
Type of Building:		Best Time to Contact you: AM PM
Computer Location:		Type of Basement:
Current e-mail address:
Where did you hear about our service? (Enter person's name if this is a referral)
Desired Service:

Please note anything special we should know such as directions to your home or office, a location where the antenna must be mounted, a location where the antenna can not be mounted, existing network wiring, network hubs or routers, etc.