BrightWireless Internet Site Survey Form

Please fill out this form and submit it. We will complete your Site Survey and contact you with the results as soon as possible.

Name :

Address :

City :

Phone :

Email : (If applicable)**

Nearest Crossroad :

Brief Description of House or Business :

Do you have a current Internet Provider?         Yes         No

If Yes, who?

* Note: Due to franchise restrictions, we can only serve Seneca County and the Fostoria area.
** Email addresses are used for contact purposes only and will not be given out to anyone.

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