Cable2¨ ANTENNA PROGRAM APPLICATION
 
* Required Field
To apply to participate in SES AMERICOM's Antenna Prgram, complete this application and return it to the address shown below.
If you are applying for more than one antenna package, please photocopy this form.
Indicate your preference for either a Standard Antenna Package or an Antenna Retrofit/Upgrade Kit
Standard Antenna Package Antenna Retrofit/Upgrade Kit
 (select one)
3.8 Meter Antenna
Dual Satellite Feed System
Four (4) LNBs
Pipe Mount Hardware
800 Ft. RG 6 cable and connectors
Installation and instruction manuals
Freight cost to CONUS locations		 Retrofit/Upgrade kit (for use with antennas including Simulsat")
Aperture 		Commercial Antenna System Retrofit/Upgrade kit
Brand/Aperture
Each Retrofit/Upgrade kit contains:
Dual Satellite Feed System
Four (4) LNBs
800 Ft. RG 6 cable and connectors
Installation and instruction manuals
Freight cost to CONUS locations
Key Contact: Title:
Ship-to-address for equipment (no P.O. Boxes):
Phone No.
Location where equipment will be installed:

Address where equipment will be installed:

Latitude

Longitude
Degrees Minutes Seconds Degrees Minutes Seconds

Applicant hereby certifies that its current subscriber count is

PLEASE REVIEW TERMS AND CONDITIONS ON REVERSE AND SIGN TO INDICATE ACCEPTANCE
   
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