Internet Application - Douglas County PUD

Internet Application

Name(Required)

First Last

Business Name

Billing Address(Required)

Street Address City State ZIP Code

Phone(Required)

Email(Required)

Service Address(Required)

Street Address City

Do you own or rent this property?(Required)

Own

Rent

Do you have a router?(Required)

Yes

No

I don’t know

Do you require In-Home Installation?(Required)

Yes

No

I don’t know

Additional information you would like us to know: