Please complete the form below:

Pricing Details
Monthly Fee *

*Month to month agreement

1. Please Provide Your Contact Details
Registered Business Name**
What is your DISH Retailer ID?
Please select your Hardware Provider.
First Name
Last Name
Email Address
Phone (Business)
Phone (Cell)

**Must be that which is on file with DISH

Address
City
State
Zip Code
Country
2. Enter Your Billing Address   3. Enter Your Credit Card Information
Same as contact address
Credit Card Billing Address
City
State
Zip Code
Country
Credit Card Type
Card Number
Name on Card
Expiration
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4.Comments/Notes
5. Confirm Your Registration
Please carefully review the information you have provided before clicking the button below.We will send confirmation of your new account to the e-mail address you entered.
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