Broadband Infrastructure ProgramExpression of Interest

Provider Information

Provider title *

Provider type *

For profit enterprise
Nonprofit enterprise

Business address

Website

Provider Contact

First name *

Last name *

Title *

Phone number *

Email *

Political Subdivision

Entity type *

County
City/town
Other
We request that the State of Arizona act as one or more required political subdivision

Entity name *

Mailing address

Political Subdivision Contact

First name *

Last name *

Title *

Mailing address

Phone number *

Email *

Project Information

Project name *

Project type

Last Mile
Middle Mile

Project description *

Project history *

Project Budget

Total project cost *

Total NTIA grant funds to be requested *

Total matching contributions identified *

Projected Outcomes

Total miles of fiber/coax deployed *

Total number of communities served *

Total residences served *

Total businesses served *

Total anchor institutions served *