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Ben Lomand Connect
Broadband Survey
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Broadband Survey
Do you currently have Internet service at your home?
*
Yes
No
If you selected Yes, who is your current Internet provider?
*
AT&T
HughesNet
Monster Broadband
ViaSat
Comcast
Charter/Spectrum
Frontier
Cell Phone Hotspot or MiFi device
Other
Are you satisfied with the speed and reliability of your Internet service?
*
Yes
No
Please explain why you are not satisfied:
Number of people living in household:
*
1
2
3
4
5 or more
Does anyone in the household have health needs that high-speed Broadband would help?
*
(Connecting online with doctor's office or the V.A., telemedicine, online prescription refills, medical monitoring, etc.)
Yes
No
Please explain:
Is anyone living in the household disabled?
*
Yes
No
Please explain:
Are there students in the household that need reliable, high-speed Broadband for schoolwork?
*
Yes
No
Please expain:
Does anyone in the household need reliable, high-speed Broadband to work from home?
*
Yes
No
Please explain:
Do you run a business from home?
*
Yes
No
Please explain:
Do you participate in farming activities (crops, livestock, etc.)?
Yes
No
Please explain:
Are you interested in high-speed Broadband service from Ben Lomand Connect?
*
Yes
No
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
ZIP Code
Phone
*
Email
*
Please share any additional comments:
CAPTCHA
Residential
Internet Services
Digital TV
Voice Services
Medical Alert System
Home Security & Monitoring
Bundle Plans
Total Connect
Business
Managed IT Services
Business Internet Services
Business Phone Services
Digital TV
Hosted Phone System
Business Security & Monitoring
Network Support for Business
Sign Up for Services
My Account
Online Bill Pay
Webmail (blomand.net)
Webmail (benlomand.net)
Webmail (Volfirst.net)
Greymail
Apps Portal Login
News
News & Announcements
BL Connection Magazine
About Us
Our Company
Board of Directors
Management Team
Jobs
Scholarships
Youth Tour
Contact Us
Register for Online Account Access
Reset My Password
Make a One-Time Payment