*Completing this form does not warrant any obligation for Peoples to provide service. Name(Required) First Last Phone(Required)Email(Required) Address(Required) Physical Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Current Internet Provider(Required)Who is your current internet provider? Aid to ConstructionAid to Construction is an upfront financial payment to offset fiber deployment costs. Any potential costs would be identified during the review process. Would you be willing to pay Aid to Construction?(Required) Yes, I would be willing to pay Aid to Construction. No, I would not be willing to pay Aid to Construction. Additional Comments