Your Name Service Address City Billing Address Contact Phone Number Employer Birthdate Video Service Number of TV's (includes 2) * Additional TV's are $5.95 Number of HD TV's ($9.95) Number of DVR TV's ($9.95) Number of HD/DVR TV's ($15.95) HBO $13.95 Starz! $12.95 Showtime $12.95 Cinemax $12.95 Broadband Service 3M/512K Username (up to 24 characters) Password (4-8 characters)