Kalona Interest Form Sign up here to help bring Fiber to the Home services to your neighborhood! First Name * Last Name * Email Address (All correspondence including your service agreement, installation scheduler, and billing information will be sent to this email address.) * Service Address City State Zip Mailing Street Address * Mailing City * Mailing State AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Mailing Zip Primary Phone Number * Secondary Phone Number Who is your current Internet Provider? Mediacom Windstream Cloudburst 9 Wireless/Satellite Provider Other Who is your current Phone Provider? Mediacom Windstream Who is your current TV Provider? DISH Other KCTC Service Are you interested in? Phone Internet TV Security Cameras Phone Systems IT Support Services How did you hear about us? WebsiteWeb AdEmailDirect Mail (letter/postcard)Yard SignVehicle DecalRadio AdRadio Talk ShowTV AdTV News StoryNewspaper AdNewspaper ArticleA FriendDoor to Door SalespersonFacebookEventOther Door to Door Salesperson Friend's name Are you currently in a contract? Yes No Date Contract Ends I would like KCTC Fiber to come to my neighborhood faster and you can contact me to get my neighbors to also commit to KCTC services? * Yes! Not at this time. Are you ready to pay your pre-registration payment? Yes, I would like to pay via PayPal/Credit Card Yes, I would like to pay via sending in Cash/Check Not a this time. Would you like a yard sign in your yard? Yes No Questions? Comments? Captcha If you are human, leave this field blank. Submit
