Name:

Address:

Email Address:

Daytime Phone:

Home Phone :

What type of converter is the digital box?
The model # can be found on the front of the converter.

Explorer 3000	Explorer 3100	Explorer 3200
Explorer 3100 HD       (High Definition)	Explorer 3250 HD       (High Definition)	Explorer 8000 PVR       (Personal Video       Recorder)

View Date:

Approx. Start Time:

Service: (from Service Portal categories)

Movie	HBO	SHO	TMC	MAX
Adult	Starz	Kid Unl.	Local	Sportskool
HGTV	DIY	Food	Fine Living	Shrewsbury

Title/Program Name:

Error Code (if any):

VCR-Type Function Problems:

Picture Break-Up on Start:

Picture Break-Up During:

Video Stopped Unexpectedly:

Other Problems: