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Contact's name:	Title:
Organization name:
Mailing Address:	Physical Address (if different):
Telephone number: (        )	Fax number: (        )

Do you have access to email? Yes    No If yes, then please provide us with an email address where we may contact you. Does your community have a website? Yes    No If yes, may we have the URL to add your community homepage to the Aboriginal Canada Portal site? If no, are there any plans to have one developed in the future? Yes    No    Don't Know

Is there telephone access for the Band or Community Administration office? If yes, what telephone company provides you with service. No    Yes    Telephone co:

Does the Band or Community Administration office have access to the Internet? If yes, what type of connection do you have? dial-in (modem)    ADSL (high speed telephone line service)    Cable    Satellite    Don't know

Are there long distance charges for its use? Yes    No    Don't Know

Do you encourage the use of the Band or Community Administration office's Internet connection by the general population? Yes    No    Don't Know

Is there telephone access for community residences? Yes    No    Don't Know If yes, what telephone company provides you with service?

If yes, what type of connection is used? Yes    No    Don't Know If yes, what telephone company provides you with service? dial-in (modem)    ADSL (high speed telephone line service)    Cable    Satellite    Don't know Are there long distance charges for its use? Yes    No    Don't Know

What is your community's official name?

How many people live in your community?

Is your community dispersed over more than one site? Yes    No    Don't Know If yes, is the level of communication infrastructure consistent across all sites? Yes    No    Don't Know

Have any comments you'd like to share?

We thank you for your time and participation with this questionnaire. If you have any questions or require further information either on the questionnaire or the Canada Aboriginal Portal site you may contact us at 1-888-399-0111 or you may write to us at ACP@inac.gc.ca

If you have access to the Internet come and visit!
www.aboriginalcanada.gc.ca

Community Name:
Contact Name:
Title:
E-mail Address:
Telephone:		Fax:

1.	Is your band office on a reserve?   "This question applies for First Nation's only."	Yes    No
2.	Do you have telephone access?	Yes    No Which telephone company:
3.	Is your telephone service provided by satellite?	Yes    No    Other:
4.	Do you have access to the Internet?	Yes    No
	If yes, which type of connection:	Dial-in (modem) while incurring long distance charges Dial-in (modem) without incurring long distance charges ISDN One way Satellite (Satellite down, telephone up) Two way Satellite (Satellite down and up) Wireless ADSL (high speed telephone line) Cable T1/T3 Other
5.	Can members of the general population have access to the Internet using the Band or Community Administration office's Internet connection?	Yes    No
6.	Does your community have a Web site?	Yes    No  eg. http://www.aboriginalcanada.gc.ca
7.	What does your Web Site offer?  (select all types)	E-Commerce  (do you sell items online)? E-Tourism  (do you promote your community as a tourist destination)? Culture  (do you promote your art, language, history, festivals or celebrations)? Community use only  (inform community members of events and activities)
8.	Which language does your band prefer to use on the Internet?	English French Inuktitut Ojibway Cree Other:

9.	Do residents of your community have telephone service at home?	Yes    No
10.	Do residents have Internet access?	Yes    No
11.	What is the fastest method of connection available to your residents?	Dial-in (modem) while incurring long distance charges Dial-in (modem) without incurring long distance charges ISDN One way Satellite (Satellite down, telephone up) Two way Satellite (Satellite down and up) Wireless ADSL (high speed telephone line) Cable T1/T3 Other   Slowest   | | | | | | | | v   Fastest
12.	What percentage of your residents subscribe to an Internet service?	More than 75% 51% to 75% 26 to 50% 1% to 25% None
13.	What percentage of your residents subscribe to a satellite television service?	More than 75% 51% to 75% 26 to 50% 1% to 25% None
14.	How important is Internet services to your community?	1 - Essentiel 2 3 - Important 4 5 - Not important

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