Your Name Service Address City Billing Address Contact Phone Number Employer Birthdate Home Phone Service Current Home Phone Number Check here to keep the same number Long Distance Video Services 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