Email Registration

You are allowed up to five (5) netINS email address accounts with your Corn Belt Telephone internet service. You are not required to have a netINS email account. However, if you would like to take advantage of this free benefit, please complete the form below.
Type of Account*

IndividualBusiness
Name on Corn Belt Account*
Full Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Home Phone
Cell Phone*
Work Phone
Mother's Maiden Name*
Choose your netINS email user name(s):
#1 netINS USER NAME:*
@netins.net
Real Name*
#2 netINS USER NAME:
@netins.net
Real Name
#3 netINS USER NAME:
@netins.net
Real Name
#4 netINS USER NAME:
@netins.net
Real Name
#5 netINS USER NAME:
@netins.net
Real Name
Email inboxes in excess of 5 are available for $5.00 per mailbox, per month. A signature is required to process your order. Your signature below indicates acceptance of the billing terms and the netINS terms and conditions.
Signature*

Clear
Today's Date*

MonthDayYear
Please verify that you are human*
Should be Empty:

Choose your netINS email user name(s):