American Satellite Gift Offer Form

 

Please print this page, fill the form in, attach the sixth months bill, certified money order for $39.99, and send to:

P.O. Box 881213
San Diego, CA 92168

Print The Name Of The Gift You Would Like:

____________________________________

 

Your Information:

DISH Network Acct. #: _________________________________________
Name: _________________________________________
Address: _________________________________________
City: _________________________________________
State: _________________________________________
Zip: _________________________________________
Phone: _________________________________________
E-mail: _________________________________________
Signature: _________________________________________