Address Submission Form

(Address input) Fiber Interest

Thank you for your interest in Premier Communications. At this time, the address you entered is not in our records, but please submit the form below to express your interest in fiber from Premier Communications. Then, tell your friends and neighbors; your interest may influence our future building plans!

If Premier Communications expands to your area, we will reach out to you.

Which type of service are you interested in? *

Residential

Business

Customer Information

First Name *

Last Name *

Business Name *

Email *

Primary Phone *

Primary Phone Type *

Cellular

Landline

Secondary Phone

Secondary Phone Type

Cellular

Landline

What type of business?

Number of employees

Service Address

Street Address *

City *

State *

Zip *

Mailing Address

Is your Mailing Address different than your Service Address? *

Yes

Mailing Address *

Mailing City *

Mailing State *

Mailing Zip *

Home Ownership Information

Do you own or rent the location you would like a fiber connection? *

Own

Rent

Landlord First Name *

Landlord Last Name *

Landlord Email

Landlord Phone *

Interested Services

Which Premier Communications services are you interested in? *

What Premier Communications services are you interested in? *

High Speed Internet

Digital TV

Digital Voice

Phone Systems or Hosted Voice Services

Who is your current internet provider?

Who is your current phone provider?

Who is your current TV provider?

Who can we thank for referring you to us?

How did you hear about us? *

Community Event Name? *

Premier Communications Employee Name? *

Friend or Neighbor Name?

Other

Premier Communications yard signs are a great way to increase interest in your area, would you like to have a sign placed in your yard?

Yes

Do you have any questions or concerns that our team can answer for you?

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If you are human, leave this field blank.

339 1st Ave NE, Sioux Center, IA 51250 800-741-8351

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