HOME | CONTACT * Indicates required field I. CONTACT INFORMATION Please provide your contact information: First Name* Last Name* Title* Name of Town or Company* Division/Mail Stop* Company Street Address 1* Company Street Address 2* Company Suite Number* Company City* Company State* Company Postal Code* Country* Business Phone Number* - - Business Fax Number* - - International Phone Number* International Fax Number* Email Address* II. INTEREST LEVEL IN BUILDING A BROADBAND WIRELESS NETWOR (SELECT ONE) End user curious about broadband wireless technology Entrepreneur looking for a profitable turnkey system Entrepreneur looking for a profitable franchise Existing business owner looking for new revenue streams Existing ISP looking to add broadband wireless service to portfolio Existing Wireless ISP looking for the best equipment money can buy Municipal Government wanting to build city-wide network Venue/Property Managment seeking Wi-Fi indoor/outdoor hotspots III. WHERE WOULD YOU LIKE TO BUILD YOUR NETWORK? City* Postal Code County State/Province Country Area to be served* Select One Inner City District Metroplex Rural Area Suburb Retail Location Estimated Area's population* Select One < 5,000 5,000-10,000 10,000-50,000 50,000-100,000 100,000-500,000 500K-1 million 1-3 million 3-6 million more than 6 million IV. TYPE AND SIZE OF PLANNED NETWORK What type of wireless network do you plan to build?* Select One Wireless Internet Service Provider Indoor HotSpot Outdoor HotSpot Corporate Campus Municipal Network Point to Point Link Point to Mulitpoint Links Wireless Local Area Network Wireless Wide Area Network What time frame do you plan to begin network construction?* Select One 1-3 months 3-6 months 6-12 months 12-24 months more than 24 months How many new Wireless POPs or Wireless Access Points do you plan to add to your network in the next 6 months? Select One 1-5 cells 5-10 cells 10-30 cells 30-100 cells 100 plus cells How many new Wireless POPs or Wireless Access Points do you plan to add to your network in the next 12 months? Select One 1-5 cells 5-10 cells 10-30 cells 30-100 cells 100 plus cells V. PLANNED WIRELESS SUBSCRIBER REVENUE Not sure how much I should charge How much does a T1 cost? Select One <$300 $301-500 $501-700 $701-$1,000 >$1,000 How much do you plan to charge business customers for a 1.5 Mbps? Select One <$100 $101-500 $301-700 $501-$1,000 >$1,000 How much do you plan to charge residential customers for a 256 Kbps? Select One <$20 $21-30 $31-40 $41-50 $51-75 >$75 How many potential residential subscribers could your entire system reach or bypass? Select One Less than 5,000 residential customers 5,000-10,000 10,000-50,000 50,000-100,000 100,000-500,000 500,000-1 million 1 million or more potential customers How many potential business subscribers could your entire system reach or bypass? Select One Less than 5,000 business customers 5,000-10,000 10,000-50,000 50,000-100,000 100,000-500,000 500,000-1 million 1 million or more potential customers VI. ADDITIONAL SERVICES PLANNED FOR CUSTOMER BASE (Check All That Apply) Email Hosting Application Hosting Virtual Private Networks (VPN) Wired LAN Installation Wireless LAN Installation Network Management Services Network Planning and Installation Services Point-to-Point Backbone Links Point-to-Multipoint Links Residential Service Business Service Hot Spot Access Point Service In-Home Wireless Networks Voice over IP Web Hosting / Collocation Web Site Design VII. PLANNED NETWORK BUDGET What type of budget do you plan to work with?* Select One less than $25,000 $25,000-$50,000 $50,000-$100,000 $100,000-$500,000 $500,000-$1 Million $1-3 Million $3-6 Million more than $6 Million How much do you plan to spend on wireless equipment in the next six (6) months? Select One Less than $5,000 in the next 6 months Between $5,000-$10,000 Between $10,000-25,000 Between $25,000-$50,000 Between $50,000-$100,000 Between $100,000-$500,000 $500,000-$1 million $1 million + How much do you plan to spend on wireless equipment in the next twelve (12) months? Select One Less than $5,000 in the next 12 months Between $5,000-$10,000 Between $10,000-25,000 Between $25,000-$50,000 Between $50,000-$100,000 Between $100,000-$500,000 $500,000-$1 million $1 million + How much do you plan to spend on IP Networking equipment in the next six (6) months? Select One Less than $5,000 in the next 6 months Between $5,000-$10,000 Between $10,000-25,000 Between $25,000-$50,000 Between $50,000-$100,000 Between $100,000-$500,000 $500,000-$1 million $1 million + How much do you plan to spend on IP Networking equipment in the next twelve (12) months? Select One Less than $5,000 in the next 12 months Between $5,000-$10,000 Between $10,000-25,000 Between $25,000-$50,000 Between $50,000-$100,000 Between $100,000-$500,000 $500,000-$1 million $1 million + What time frame are you expecting to see a return on your investment? Select One 6-12 months 12-18 months 18-24 months 24-36 months 36-48 months more than 48 months VIII. SERVICES WE WOULD LIKE TO RECEIVE INFORMATION ABOUT (Check All That Apply) Turnkey Systems Broadband Wireless Franchise Business Planning Services Consulting Services VoIP Services and Support Grant Writing Services CATV Design & Services 24/7 End User Support Installation Services (CPE, headend and tower construction) Financial Planning and Management Services Network Baseline Planning, Design and Management Services Operations Support Systems and Branded Billing Systems Other IX. BROADBAND COMPETITION Are there any broadband providers in your area now?* Select One yes no not sure Pleck check any broadband competitors that are already available: Cable Modem DSL Modem ISDN Modem Satellite Modem Wireless Modem X. LANDSCAPE TOPOGRAPHY/GEOGRAPHY OF NETWORK LOCATION What does the landscape look like? Please select all that apply: Flat Plains Rolling Hills Very Large Hills Mountains Light Foliage Medium Foliage Heavy Foliage Tall Buildings Swamps Large Bodies of Water XI. NETWORK FINANCING How do you plan to finance your network build out ? Personal Credit Cards SBA Loan Local Bank Line of Credit Bond Election Vendor Lease Financing Cooperative Funding State/Local Grants Venture Capital Other Are there any local or state programs that provide grants or public money to help fund your network build out? Select One yes no not sure Would you like assistance filing the appropriate paperwork to secure these grants/low interest loans if available? Select One yes no not sure Would you like assistance finding a venture capital firm to provide startup funds? Select One yes no not sure XII. BUSINESS EXPERIENCE Have you managed a business before? Select One yes no not sure   Number of years Do you have any Internet Service Provider or Networking experience? Select One yes no not sure   Number of years Do you have any experience working with Radio Frequency technology? Select One yes no not sure   Number of years Are you involved with any local government officials or large group of business leaders that could help you win community approval to build out a high-speed network in your area? Select One yes no not sure What level of purchase authority do you have?* Select One researcher recommend specify approve purchase final decision maker

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