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Wireless Internet survey request

Tell us how to get in touch with you: First Name Required Last Name Required E-mail   Telephone Required Tell us where to do a site survey: *Street Address Required Town Required Province Postal Code Promotional Code * please provide an actual street address. No P.O. Box numbers or Rural Route numbers. Our technicians will need to find the actual location in order to test for service availability. How do we find you?:  (Please provide directions from the nearest main intersection. Many times streets are not listed as named or are not listed in map software. If you have access to GPS coordinates this will speed up the process.)