Request Wireless Site Survey

Wireless Site Survey Request Form

To schedule a site survey, please use this form to provide us with your contact information, and the address where you would like to have service. If you prefer to schedule the site survey by phone, please call 765-482-8881.

First Last - First and Last Name are required

(xxx) xxx-xxxx

Street Address

If a rental or appartment please read the rental section of our FAQ

To properly perform the survey our technician needs to know all the possible locations you would allow equipment to be installed. Check all that apply.

Any other information about your property that you think is needed.

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