Apply for Service!


Apply For Service

New Customer to Corn Belt Telephone?

To apply for services with Corn Belt Telephone, all customers are required to fill out a Corn Belt Telephone Service Application and a CPNI Account Password Form. In addition to these, our internet customers are required to sign our High Speed Internet Service Policy Form. For our customers that would like to sign up for auto pay, please fill out either our Debit Authorization Form for automatic withdrawal from your checking account or the Credit Card Payment Authorization Form for a monthly charge to your debit or credit card.

All forms are available below.
Please return your completed forms, along with your one time deposit to us at our office, in our night deposit located on the front right of our building by the alley, upload your forms using the "Submit Your Forms" option on the bottom of this page or fax them to 712-664-2083.

Corn Belt Telephone Residential Service Application -required for all residential services

Corn Belt Telephone Business Service Application - required for all business services

Email Registration - for Internet customers that want to take advantage of up to 5 free email addresses

Automatic Payment Authorization - optional

Account Update Form - required for existing customers that wish to add a service, move services to a new location, or add an authorized user


Know that you are going to want it? Tell us! Fill out this quick online form requesting that we bring Fiber Optic Services to your home or business! There's no obligation to sign up for services with this form, and no cost to you for us to bury to your location, as long as we can get you on our way!

Sac City Fiber-to-the-Home Forms

Fill this form out prior to CBT burying Fiber to your home/business.

Corn Belt Telephone Fiber Request Form- required for all Sac City customers prior to CBT burying Fiber to you home or business.  You can fill out this paper form and return it to us, or this eForm and submit it online.


Fill these forms out when you are ready to activate service.

Corn Belt Telephone Residential Service Application -required for all residential services

Corn Belt Telephone Business Service Application - required for all business services

Automatic Payment Authorization - optional

Submit Your Completed Forms

Your Name (required)

Your Organization

Your Email (required)

Phone Number (required)

Special Instructions, Notes or Information Not Included on Form (required)


Upload up to five application documents at a time.

By checking this box I acknowledge that I am sending forms or information to Corn Belt Telephone electronically. I understand that Corn Belt Telephone does not store my information on their website.

Our Contact Info

Corn Belt Telephone Office Hours
8:00 am - 5:00 pm - OPEN
(12:00 pm - 1:00 pm - CLOSED for lunch)

108 Main Street
PO Box 445
Wall Lake, IA 51466

Phone: (712) 664-2221
Fax:  (712) 664-2083


Email questions to