PHONE: __________________________________

E-MAIL: ___________________________________________________________

PHONE: ________________________________

E-MAIL: ___________________________________________________________

WHAT DO YOU WANT YOUR URL (WEB ADDRESS) TO BE?
www._________________________________________________.GeorgiaRedHat.net
(We suggest you use your chapter name in the blank area, and do not preface with "the". Also keep in mind that whatever you use is case sensitive, so its best to keep it all lower case letters)

WHAT DO YOU WANT YOUR ACCOUNT PASSWORD TO BE? _______________________________
(We suggest something easy to remember, security is not the issue, we just want to separate the accounts so that you will not have another chapter accidently overwrite your files.)

Enclosed is $20 to purchase 50 MB of hosting space for my Red Hat Sociery chapter, renewable at my option on a yearly basis. I agree to abide by all the guidelines set forth by National concerning chapter web sites and will use the hosting space for my chapter site files only. I understand that any other use will be grounds for termination of my account. I agree to not hold the Red Hat Society, the developers of Georgia Red Hat.com, the developers of Georgia Red Hat Chapters.com, nor any afliates of the above, responsible for any damages or loss of any kind arising out of or related to my use of this shared web hosting space. The hosting service we have contracted with does make certain guarantees that the service will perform to standards and any complaints will ultimately be directed to them. I understand that although Georgia Red Hat.com will be offering web development workshops which I may opt to make use of, it is still my responsibility (or someone I designate) to build and maintain my web site; what I am purchasing here is the hosting space only.

signature:	_____________________________________________
date:	________________

Mail application along with your check to:
Marsha Elliott
10690 Centennial Drive
Alpharetta, GA 30022

You will then receive an email confirmation that your hosting account is active, along with your user name and password needed to access the account.