Internet Access Survey for Pembroke Township and Hopkins Park Residents

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To help us address internet access disparities please complete this survey.

Household size: *

Do you have internet [broadband/ Wi-Fi or Online] access at home? *

yes

I do not know

Mark all that apply

There are no internet service providers servicing my home.

I cannot afford internet service.

I do not know how to use the internet.

I do not own a computer, laptop or a tablet.

I use internet only on my smart phone.

I have dial-up/landline internet.

I use an internet hotspot.

I use satellite internet

How many people in your household use the internet? *

What are the age groups in your house? *

0 - 14

15 - 18

19 - 24

25 -54

55 +

Required

How much does your household spend online monthly for shopping [food/clothes/ other] or services [gaming/music/TV/other subscriptions]?

0 - $25

$26 - $100

$101 - $500

$501 +

Clear selection

How often is the internet used per day?

0 - 4 hrs

5 - 10 hrs

11 - 18 hrs

19 - 24 hrs

Clear selection

What are the reasons for internet access? *

Work

School

Entertainment

Telehealth/Telemedicine

Other

Required

Would you be willing to participate in a virtual community meeting to further converse about internet access in Pembroke Township?

Yes

Maybe

Clear selection

Name *

Would you like to join our email list? *

Yes

Do you live in Pembroke Township or Hopkins Park? *

Pembroke Township

Hopkins Park

Other:

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Suggestions for improvement

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