Select Equipment
How many TVs do you want to connect?
Choose the equipment you want installed:
Choose equipment options:
Do you have an Active Land-Line Phone Connection? * No Yes
Active Land-Line Phone Connection DIV
Select Dish Network programming package!
Select Premium Movie Channels:
International Programming & Sports Packages:
Satellite Equipment and Installation:
Fees:
Monthly Charges Estimate:
Premium Movie Channels
TOTAL
*
Qualifying programming for both new and existing customers under this offer consists of DishHD Bronze or higher. New and existing subscribers need to submit a completed redemption form. Customers can download the redemption form from www.dishnetwork.com/100back
**
Qualifying HD programming for both new and existing customers under this offer consists of DishHD Bronze or higher. New and existing subscribers need to submit a completed redemption form. Customers can download the redemption form from www.dishnetwork.com/100back
New customers participating in both the $100 HD Bonus and the $100 Back Offer need only submit the single form, as it applies to both offers.
Installation & Billing Details
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Please select a few preferred installation dates and times. *
Contact Details: Installation Address:
Provide additional installation instructions if needed:
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