seasonal customer return

Name *

First

Last

Email *

Confirm Email

Phone *

Service Address *

Address Line 1

Address Line 2

City

State

Zip Code

Date to resume service: *

Service must be resumed on a weekday. If a weekend date/holiday is selected, service will resume on the prior business day.

Resume all prior services? *

Do you have a different mailing address? *

Notes

Confirmation *

Yes, I am requesting that Corn Belt Telephone resume my services indicated above, on the date indicated above. I understand that if I have chosen a non business day for service to resume, service will be re-activated on the prior business day. I understand that billing for these services will resume on the date I have indicated above.

Name

Seasonal Customer Return