TV/CABLE SALES

TV SALES/REFERAL SERVICES

TIRED OF PAYING TO MUCH FOR TV PHONE AND INTERNET SERVICES? CALL TODAY AND START SAVING
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Apartment or Unit # *
Also floor number if needed
Phone Number *

Area Code Phone Number
E-mail *
HOW DID YOU FIND US? *
DO YOU HAVE ACTIVE SERVICE OR ARE YOU DISCONNECTED? *
WHAT SERVICES ARE YOU INTERESTED IN? *
WHAT PROVIDER DID YOU HAVE THAT YOU WERE DISCONNECTED FROM? *
HOW LONG HAVE YOU BEEN DISCONNECTED? *
PLEASE TELL US WHY YOU WERE DISCONNECTED?
HOW MUCH ARE YOU PAYING PER MONTH FOR SERVICE? *
WHAT PRICE RANGE WOULD YOU LIKE TO BE IN FOR CABLE/INTERNET? *
IF YOU WANT JUST INTERNET WHAT PRICE RANGE WOULD YOU LIKE TO BE IN?
HOW MANY TV'S DO YOU NEED CONNECTED? *
IS THE SERVICE THAT IS DISCONNECTED IN YOUR NAME OR SOMEONE ELSE NAME? *

MY NAME SOMEONE ELSE
IF YOU HAVE USE YOUR NAME AT THIS ADDRESS BEFORE PLEASE PROVIDE A DIFFERENT FIRST AND LAST NAME!!!
IF YOU HAVE USE YOUR PHONE NUMBER WITH A PREVIOUS ACCOUNT PLEASE PROVIDE A DIFFERENT NUMBER
IF WE ARE NOT ABLE TO REACH YOU DO YOU GIVE US PERMISSION TO COMPLETE YOUR ORDER? (IF WE ARE ABLE TO COMPLETE IT WITHOUT NO MONEY DOWN) *

YES NO
IF WE ARE ABLE TO COMPLETE YOUR ORDER CAN WE.......

CALL TEXT
WHAT TIME WOULD YOU LIKE A CALL BACK ( between 10am-10pm CST)?
How soon do you need service?
PLEASE GIVE REFERENCE OF ANY 4 PEOPLE WHOM YOU FEEL NEED SERVICE RECIEVE $25 FOR EACH PERSON THAT IS INSTALLED (NAME AND PHONE NUMBER)
RECIEVE $25 FOR REFERAL THAT IS INSTALLED
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TV SALES/REFERAL SERVICES