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LGD OF PINAWA – ORDER FORM is Pinawa’s Provider for Shaw) Direct Digital 100% Digital Satellite TV

Please remit completed form to: LGD of Pinawa, Box 100, Pinawa, MB R0E 1L0 Or return in person to the Municipal Office

❑ I wish to sign up for Shaw Direct effective ______

❑ I wish to cancel my Shaw Direct effective ______

* You will be billed for the month in which your Shaw Direct was cancelled * I understand if I wish to sign up for Shaw Direct Satellite TV, I will need to wait 1 year from date of cancellation.

Essential Information

First Name Street Address Surname Mailing Address Phone Number City/Province Pinawa, Alt Phone Number Postal Code R0E 1L0 Email Address I own this property ❑ I do not own this property ❑

Your Programming Your Hardware

English Essentials $0 (included)  and Basic Installation $0 (included)  Pinawa Selected Bundles $0 (included)  DSR 800 – Essential Receiver $0 (included)  (Real Life, Lifestyle, Sports, Primetime, Timeshift)) Upgrade to an Advanced HD PVR830 $199.99 ❑

Crave + HBO + Movies $20.00 ❑ Additional Hardware * ** Cost Quantity Super Channels $10.00 ❑ HD DSR 800 Essential Receiver $149.99 each ❑ Hollywood Suite $7.00 ❑ Advanced HDPVR630 $299.99 each ❑ $10.00 ❑ ND Additional Bundles $8.00 ❑ 2 Receiver Discount $50.00 ❑ Subsequent receiver(s) regular price Pick and Pay any 10 Channels $24.00 ❑

*$50 installation fee for any lines needed for additional receivers.

Please review the following link for bundle options: ** If your account has 2 or more receivers there will be an http://www.shawdirect.ca/english/packages/programming/bundles additional monthly Multi-Receiver charge of $5.99. First six (6) months are no charge.

Signature Date

OFFICE USE ONLY

Remitted to Shaw Direct via Email ______

Invoice / Refund Provided ______