Colorado Valley Interest Form Colorado Valley Interest Form First Name * Last Name (Legal) * Service Address * City * State * Zip * High Speed Broadband Community Primary Phone * Secondary Phone Email ( All correspondence including your service agreement, installation scheduler, and billing information will be sent to this email address. ) * Preferred Contact Method * Phone Email No Preference Are you an existing customer? * Yes, I'm existing customer No, I am not a current customer Who is your current Internet Provider? * New Wave Frontier AT&T- Satellite AT&T- Wireless SCT Broadband OtherOther Who is your current Internet Provider? * Colorado Valley Communications How did you hear about Colorado Valley Internet? * Email Facebook Referred by friend/neighbor Radio Ad Connection Magazine Community Event Employee Web Advertisement Newspaper Ad Yard Sign Direct Mail Service Truck Billboard Web Search Other Employee Name * How soon will you need service? * Within 7 days Within 14 days Willing to wait until High Speed Broadband is ready Comments reCAPTCHA
