Enter your billing information as it appears on your credit card statement. Your card will not be
approved unless you enter the correct billing address.
Check here if credit card billing address is the same as
home address above.
first name
initial (optional)
last name
address
additional address (optional)
city
state
(not offered in Alaska)
zip code
daytime phone number
- - (incl. area code)
evening phone (optional)
- - (incl. area code)
3. Select Satellite Package (You can upgrade to 100 hour DVR's [digital video recorders]
on any plan for an additional $5.98 per month.)* After you complete this order form, we will schedule your installation. You
can tell us whether you need DVR's and/or High Definition receivers at that time.
One Room
Two Rooms
Three Rooms
Four Rooms
I'll choose plan at a later time.
4. Complete Payment Information
All credit card information is sent through Verisign's™ Payment Gateway via 128 bit SSL Encryption.
The highest level of encryption available!
5. Submit Order By clicking on the submit button, you are certifying that you agree to our
Terms and Conditions and understand the disclosures at the bottom of this page. Once you click submit we will process a charge
to your credit card. We will charge your credit card $49.99 which covers Activation and FREE INSTALLATION! After
your system is installed, we will place a $49 credit on your first DISH Network bill.* This means you pay nothing for your
equipment or installation! Only click the submit button once or you may be charged more than one time! It may take several
seconds while we process your credit card. After we have charged your card, you'll be ready to schedule your installation!
Your order includes: $100 Rebate on qualifying programming packages! 8 Free movie channels
from STARZ for three months!
