Washington Parish Government
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Washington Parish Broadband Availability Survey (WPBAS)
Prefix First* Middle Last*Suffix
Building Or House Number*Street Name*Apartment Number
City*State*Zip*
 
Phone Number* Email Address*
Do you have high speed internet) service?*
Why do you not have high speed internet service*?(Check all that apply or type in your own reason)*






How much would you be willing to pay each month for high speed internet service*?



* Indicates a field is required.