Required Information Wize Guyz Things to Remember DIRECTV

800-815-0277
DIRECTV New Customer Qualifying Worksheet
Date ___________________________ Customer ______________________ Ref. Acct# _________________________
WG Rep ___________ Promo Code _____ Bill to Address ___________________________________________________
Phone __________________________ Install Address _____________________________ City __________________
www.wizeguyzonline.com
E-mail __________________________ ST/Zip __________________ Email __________________________________
Upstate SC
Location ________________________ Phone _______________________ Cell ______________________________
Programming
Std. Fee
Choice $58.99
$29.99
$29 Rebate for 1 yr
150 + Channels
Free Showtime 3 Months
RESET Programming
Programming Add–Ons:
DVR $7
Upgrade Fee
$29 Rebate for 1 yr
210 + Channels
Free Starz & ShowTime 3 Months
Free HD with Autodraft
HD $10
Promotion
Free Cinema Kit with HD DVR
Choice Ultimate $68.99
$39.99
Choice Xtra$63.99
$34.99
Whole Home DVR $3
Switch
$29 Rebate for 1 yr
225 + Channels plus
Free Starz & Showtime 3 months
FREE HD with Autodraft
Mas Mexico + 7.99
HD X Pack $4.99
Latino Programming
HD Free
Premier
$114.99
$61.99 (Mo. 1-3), $85.99 (Mo. 4-12)
285 Top Channels
All Movie Channels & Sports Pack
Free HD with Autodraft
Mas Americas + 7.99
En Espanol $14.99
Más Mexico – 2 Std Receivers $29.99 $24.99
Optimo Más $44.99 $34.99
Más Ultra – Free HD with Autodraft $59.99 $39.99
Lo Maximo $114.99 $70.99 (Mo. 1-3), $94.99 (Mo. 4-12) Free HD with Autodraft
International
International must have base package
Basic Choice $12.99
Jade World $39.99
Preferred Choice Free HD w/Autodraft $38.99 $19.99
A la Carte package _______________________________________
standard receivers Free with Choice
RESET
Equipment •4
•1 Free Upgrade to DVR, HD DVR, or HD Receiver with Choice Xtra
•1 Additional Free HD Receiver (must have HD DVR and
whole home service)
0.00
Standard Receiver = $69.00 X
# ______ =
$ _______
Standard DVR
= $99.00 X
Name on Existing Account _________________________________________
Address ___________________________________________________
_________________________________________________________
0.00
$ _______
0.00
$ _______
0.00
$ _______
Existing: Account # _____________ Phone #__________________________
# ______ =
HD DVR = $199.00 X
# ______ =
Total Equipment Cost
=
TV Receivers
3rd TV $10
•I agree to allow us to switch my current account to Wize Guyz DIRECTV
Yes, switch me
•I declare: All contracts have expired
I am currently under contract ________________
0.00
$ _______
= $99.00 X
2nd TV $5
Please cancel for me, my current account: Charter: TV
Internet
Phone
Dish Network
AT&T: TV
Internet
Phone Other _____________
# ______ =
HD Receiver
1st TV Free
Consent to Switch
4th TV $15
Things to Remember
•Commitment is 24 months
•Estimate only – Pricing may vary
•Standard Installation Included
•If dish is on a pole, additional charges may apply
•Fee Based $200 or $300 – upgrades are more
•$19.95 S & H Fee or FREE shipping for 3 referrals:
Referral
Phone # / Relationship
1____________________________________
_________________ __________________
2____________________________________
_________________ __________________
3____________________________________
_________________ __________________
How did You hear of Wize Guyz?
Current Customer __________________________
Walk-In
Billboard
Radio
TV __________________________
Flyer - Promo Code _______________________
BP - Promo Code ________________________
SA - Promo Code________________________
Reset Entire Form
5th TV $20
6th TV $25
Transferred by : WG rep _____________________ Date _________________
By signing below, I agree to all terms & conditions on this sheet and declare all information to be true.
Signature _________________________________________________________
Wize Guyz
115 E Blackstock, Unit D
Spartanburg, SC 29301
864-576-7789 or 864-552-1070
800-815-0277
Premium Channels
HBO-$1499
Starz-$1299
Cinemax-$1299
Showtime-$1299
Sports Pack-$1299
Choose 1-$1299
Choose 2-$2400
Choose 3-$3400
Choose 4-$4200
RESET
Add $2 for any package with HBO
Preferred Install Date
AM
1st Choice _______________ PM
AM
2nd Choice_______________ PM
AM
3rd Choice_______________ PM
Required Information
MasterCard
Credit Card ____________________________
Credit
Debit
Name on Card ________________________________________
Credit Card # _________________________________________
Exp Date __________________________ 3 Digit Code ________
Social Security # ____________________ DOB_______________
Credit Card–extra equip
Mthly Draft
Mthly Invoice
0.00
Base Programming
$_________
0.00
DVR Service
$_________
0.00
Whole Home DVR Service
$_________
0.00
HD Programming and/or HD Extra Pack
$_________
0.00
International Programming
$_________
0.00
TV Receiver Lease Fees
$_________
0.00
Premium Packages
$_________
0.00
Protection Plan
$_________
0.00
Estimated Monthly Total before Rebates$_________
0.00
Discount$_________
0.00
Monthly Rebates
$_________
0.00
Estimated Monthly Total after Rebates
$_________