Republic Wireless by DISH Form

Interested in more information on Republic Wireless by DISH? Fill out the following and we will contact you to answer all of your questions. Have your 16-digit DISH account number ready. It can be found on your DISH bill or through the MyDISH App. Thank You!

Preferred Phone Plan *Only What You Need $19.99Everything You Want $29.99Everywhere You Go $39.99

Pick the Phone Plan that most interests you…

Preferred PhoneiPhone 2 SE $69.99 While Supplies LastSamsung Galaxy A13 5G $29.99 While Supplies LastSamsung Galaxy S22 5G $399.99 Ends 9/30/2022Other Phone ModelKeep My Phone – Must be Compatible with Republic Wireless

Pick the Phone that you like…

Name *

First

Last

Email *

Phone

Checkboxes

• I authorize Freedom Satellite Systems to contact me by phone and/or email about DISH and Republic Wireless by DISH even if I am on a Do Not Call List.

Checkboxes *

• I am a current DISH Subscriber
• I am not a current DISH Subscriber

Checkboxes

• My phone is paid off and I own it
• My phone is unlocked
• I have my Port Out Pin

Submit