Colorado Valley Interest Form/Address Submission First Name (Legal) * Last Name * Service Address * City * State * Zip * 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 Who is your current Internet Provider? * Colorado Valley Communications New Wave Frontier AT&T- Satellite AT&T- Wireless SCT Broadband OtherOther How did you hear about Colorado Valley Internet? * Billboard Community Event Connection Magazine Direct Mail/Post Card Email Employee Facebook Newspaper Ad Radio Ad Referred by a friend/neighbor Service Truck Web Advertisement Web Search Yard Sign Pandora How soon will you need service? * Within 7 days Within 14 days Willing to wait until High Speed Broadband is ready Are you interested in... * Adding New Service Upgrade your existing service Comments reCAPTCHA If you are human, leave this field blank.