Fiber Request Form

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Sac City Fiber Request Form

Let us know that you are interested before we pass your location.

Our plan is to build our new Fiber Optic network as efficiently as possible in order to begin providing services as soon as possible! Our Fiber Request Form lets us know who is interested in services and allows us to gather required information from these parties. Don’t worry, the information we collect will not be shared with other companies.

IS THERE AN OBLIGATION TO PURCHASE SERVICES IF I FILL OUT THE FIBER REQUEST FORM?
No. The Fiber Request Form is only a tool for us to identify those residents and businesses who are interested, allow us to begin a conversation about Fiber and plan our installations. You can get a Fiber Request Form here if you’d like to print, sign and return it to us, OR you can fill out the handy form below here on our website.

Fiber Request eForm

Your Name (required)

Your Email (required)

Phone Number (required)

Your Service Address (required)

Your Service City (required)

Your Service State (required)

Your Service Zip Code (required)

Which Corn Belt Telephone Services are you interested in?

Digital Cable TV
YesNo

Fiber Optic Internet
YesNo

Telephone (yes, you can keep your current phone number)
YesNo

Is Your Mailing Address the Same as Your Service Address? (required)
YesNo

If No, What is Your Mailing Address?

Your Mailing City

Your Mailing State

Your Mailing Zip Code

Special Instructions or Notes

By checking this box, you are requesting that Corn Belt Telephone bury a fiber drop to your home or business in order to provide services. (required)