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Grant Reporting Form

First Name

Last Name

Street Name

City

State

Zip

My Current Internet Provider

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Was this speed tested by you?

Yes

You may contact me about running a test on my network?

Yes

Have you contacted other providers?

Yes

If yes, please list them:

At my residence, high speed internet is most needed for:

The slow internet speed I currently subscribe to often prevents me from:

Phone Number

Email Address

Date

If you are human, leave this field blank.

Phone

618-665-3311

Toll Free

(800) 228-9824

24/7 Customer Support

info@wabash.net

Monday - Friday

8:00 a.m. to 5:00 p.m.

14415 US HWY 45
Louisville, IL, 62858

610 S College St
Salem, IL, 62881

113 Hagen Drive
Flora, IL, 62839

102 N Main Street
Dieterich, IL, 62424

“This institution is an equal opportunity provider and employer.”