BirdsEyeTv

Low Cost & Budget Entertainment

Affordable Tv Services
Customer Application Form

No Credit Check!
Name

First NameLast Name
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
One Device is included with your BirdsEyeTv service,,The box / Receiver is $165.99 . Service to one box is $30 , service to each additional box is $5 per box on monthly bill
Number of boxes? Additional boxes are 95.99 ea.
Desired Installation date?

MonthDayYear
Date
What’s Your Time Availability

:HourAM/PM Option
Until
until :HourAM/PM Option
Adult content
BirdsEyeTv Requires High-Speed internet. Recommeded minimum 50 mbps per stream for optimal Viewing.
Who referred you?
For BirdsEyeTv with one box , $165.99 needs to be paid, then service will be $30 per month, are you able to pay the $165.99 Today?
Will you be paying With Credit/,Debit card or PayPal Please state which one.
No Gift cards will be accepted!
Are you ok with all of the Requirements? If not please explain?
Any questions.....Feel free to call me @

423-633-2474
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My Products
prevnext( X )
Digital Box Device$165.99

Quantity

Total $0.00
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Low Cost & Budget Entertainment