*Organization Name          

*Point of Contact Name     

*Phone Number                        Extension 

*Email Address                  

Organization's URL         

*Select Your Organization Type Review Organization Type definitions


*States where you seek a partner
(For multiple choices, hold the control key while selecting.)
 

Select key partner types you’re seeking
(For multiple choices, hold the control key while selecting.)


*Provide below a brief description of your organization's interest
in the BTOP/BIP programs and/or how you might benefit potential
partners. You may also expand on the types of partners you seek.
 

*Make my information publicly searchable on Broadband Match    

Please read and confirm the following BroadbandMatch terms of service

By checking the below box and registering on this site, I hereby affirm the following:

That the Department of Commerce or its National Telecommunications and Information Administration; the Department of Agriculture or its Rural Utilities Service; nor any other government entity is responsible for management, upkeep or correctness of the information provided by me, the user.

That the Department of Commerce or its National Telecommunications and Information Administration; the Department of Agriculture or its Rural Utilities Service; nor any other government entity is responsible for public use or distribution of the information provided by me, the user.

That I, the user, am solely responsible for any actions, taken on my own part or on the part of others, that results from the submission of the information provided by me. This includes all contact, relationship management, legitimate and fraudulent representations on the part of any user or applicant, and any contractual or non-contractual partnerships that may emerge thereby. I also affirm that it is my responsibility to conduct all due diligence to ascertain the identity and reliability of any potential partners, and indemnify the Department of Commerce and its National Telecommunications and Information Administration; the Department of Agriculture and its Rural Utilities Service; and any other government entity from responsibility for outcomes and interactions, legal or illegal, between myself and my entity and other users of this site.

That all information submitted to this site is factual and correct to the best of my knowledge, and that I am an authorized representative of any organization or entity listed in my profile.

That the Department of Commerce and its National Telecommunications and Information Administration; the Department of Agriculture and its Rural Utilities Service; and any other government entity take no responsibility for the verification of any user’s identity or the factual veracity of any information in any profile.


OMB Control No: 0660-0033