King-Lincoln Bronzeville

Sign Up Form

King-Lincoln Bronzeville
Application Form - King-Lincoln Bronzeville
Please complete this registration form to get started. We’ll double-check that your home address can receive no-cost WiFi as part of our CBus WiFi pilot program. If you can receive WiFi, then we will be in touch with you to coordinate installation.

Fields marked with * are required to complete the application.

How did you hear about this program? *
Type of Home *
Do you rent or own? *
Do you expect to move in the next 12 months? *

What are the three most important things for you to be able to do online?(Check all that apply)
How are you most frequently connecting to the Internet/WiFi in your home?
How much do you currently pay for home Internet/Wifi access each month? (For example, how much you pay for internet connection to AT&T, Spectrum, Verizon, etc)
What are your three biggest issues with your current home Internet/WiFi?
About how many devices do you have in your home that you would like to connect to the Internet/WiFi?
Which of these devices do you have in your home? (Select all that apply)
Would you be interested in any of the following? (Select all that apply)
What is your preferred method of communication?

Form Submission

Please type out your full legal name in the box below, click agreement, and hit the submit button.

E-Signature Consent *

By clicking “I Agree” you consent to use your electronic signature to sign this document or communication to receive electronic delivery of any document or communication from Smart Columbus. You understand that Smart Columbus will not be monitoring any of your usage with this program. You agree to participate in this program for research purposes. You understand that the incentive to participate in this program is dependent on your participation by using the service. There are no cancellation fees if you choose not to continue participation in, or drop out of, the program. You understand that your electronic signature is legally binding just as if you had signed a paper document. If you do not click “I Agree” you may not proceed to enroll in our WiFi pilot program.

If you have a question about the form or wifi program, please text or call 614-245-2847 or send an email to 

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