Residential SMATV (MTS) New CustomerProgramming Order Form (page 1 of 3)

Complete this form on-screen, print for signature then FAX: 800 933 4631

Property Name

Please select the programming services you wish to order by checking the appropriate boxes below. Enter the package orservice price for each selection using the Residential SMATV Programming Rate Card. Use the per unit price correspondingto your number of Subscriber Units. Each programming service in a DIRECTV® package or bundled service requires adedicated DIRECTV® Receiver (IRD). In certain areas, service may be unavailable or additional restrictions may apply.

SELECT # OF UNITS PRICE TOTAL

Adventure Package $.50/unit

Business Networks $.50/unit

Disney Pack $.75/unit

ESPN Suites $3.10/unit

Facts & Fantasy $.25/unit

Fox Sports Suite $1.35/unit

The Fundamentals $1.25/unit

Family Favorites $.50/unit

Great Entertainment $.50/unit

XM Satellite Radio $.17/unit

Local Channels $49.99 Per Property

HBO The Works (7 channels & HBO Latino) $4.00/unit

SHOWTIME, FLIX & Sundance Channel $4.10/unit

SHOWTIME UNLIMITED (see Rate Card for details) $5.00/unit

Starz Super Pack/Encore $3.75/unit

SHOWTIME (5 channels) $3.00/unit

MTS Account #

Packaged Services

Premium Services

CINEMAX (3channels) $3.50/unit

Starz/Encore + 3 Themes $3.30/unit

Starz/Encore + 1 Theme $3.00/unit

Starz/Encore (see Rate Card for details) $3.75/unit

Encore + 6 Themes (8 channels) $1.95/unit

Encore + 3 Themes (5 channels) $1.35/unit

Encore + 1 Theme (3 channels) $.95/unit

Encore (2 channels: East & West) $.75/unit

Sub Total 1

Sub Total 2

Music Extra $.35/unit

Revised 1/23/2008

Residential SMATV (MTS) New CustomerProgramming Order Form (page 2 of 3)

SELECT # OF UNITS PRICE TOTAL

A&E, History Channel & Di scovery Health $.35/unitBBC America & Current TV $.20/unitBlack Entertainment TV & Gameshow Network $.15/unitBravo, Intl Film Channel & Women's Entertainment $.35/unitCSPAN & CSPAN2 $.08/unit

Turner Classic Movies & CNN $.30/unitCollege Sports Television (CSTV) $.15/unit

Disney Channel (East & West) $.75/unit

ESPN $3.85/unitESPN & ESPN2 $3.65/unitESPN, ESPN2 & ESPNEWS $3.25/unit

Fox Movie Channel $1.00/unit

Fox Soccer Channel $.20/unitFox Reality $.15/unit

FX $.30/unitFUEL TV $.20/unit

A La Carte and Bundled Services

Galavision and Univision $.15/unitThe Golf Channel $.25/unitHome & Garden, Food Network & Travel Channel $.15/unitNBA TV $.35/unitNFL Network $.30/unitNoggin, PBS Kids, Nicktoons $.30/unitSpeed Channel $.25/unitSundance Channel $.35/unitSuperstation WGN $.14/unit

TVLand, Hallmark Channel, Lifetime Movie Network $.25/unit

AASTHA $.50/unitBanglaDirect $.50/unitHindiDirect $.50/unitJADEWORLD (Jade-E&W, TVBS, Chinese Movie Channel & CCTV-4) $200 (1-999 units)

JADEWORLD (Jade-E&W, TVBS, Chinese Movie Channel & CCTV-4) $400 (1000+units)

Lo Ecsencial En Espanol: 27 Spanish Language Channels $2.85/unitMandarinDirect $.50/unitSKY TG24 $.50/unitTamilDirect $.50/unitTeluguDirect $.50/unit

International Programming

TFCDirect $.50/unitVietnameseDirect $.50/unit

Sub Total 3

Sub Total 4

Revised 1/23/2008

VISA

MasterCard

Optima

American Express

Discover Card

Recurring Credit Card

Name as it appears on credit card

Credit Card #:

Exp. Date:

Signature of Cardholder

Pricing does not include taxes.Include applicable sales tax with

total payment.

Payment Options

FSN (Fox Sports Net) $.99/unit

YES Network In Market NY, NY DMA $1.75/unit

YES Network Out of Market for NY & CT $1.50/unit

YES Network Out of Market Portions of NJ & PA (zip code Confirmation) $1.50/unit

Complimentary/Public InterestFree Add-on with purchase of any DIRECTV In-Room Programming

Sub Total 1

Sub Total 2

Sub Total 3

Sub Total 4

TOTAL

Residential SMATV (MTS) New CustomerProgramming Order Form (Page 3 of 3)

SELECT # OF UNITS PRICE TOTALRegional Sports Networks

Applicable Taxes

Electronic Funds Transfer

Routing Number Account Number

Sat 119*BYUTV 437*CCTV 455*DAYSTAR 369*EWTN 422*HITN 438 NASATV 376 RFDTV 379

Sat 101*CSPAN 350LINKTV 375PBS YOU 377TBN 372WORD Network 373

*Must have DIRECTV Multi-Satellite system to receive these channels.Procurement of equipment is customer's responsibility.

RSN (In-Market Regional Sports $.99/unit

Revised 1/23/2008