NOTE: print out this application form and fill out or write all 
required data on blank paper and send to the address noted below.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
POLARHOME.COM ROOT USER'S APPLICATION FORM


Username: _______________________________________

Host: Linux/RedHat  [ ] OpenBSD  [ ] OpenVMS/Alpha[ ] Minix   [ ] 
      Linux/Debian  [ ] FreeBSD  [ ] OpenVMS/IA64 [ ] Tru64   [ ]
      Linux/SuSE    [ ] NetBSD   [ ] OpenVMS/VAX  [ ] Ultrix  [ ] 
      Linux/Ubuntu  [ ] MirOS/BSD[ ] OpenIndiana  [ ] IRIX    [ ]
      Linux/CentOS  [ ] DragonFly[ ] Solaris/x86  [ ] QNX     [ ]
      Linux/Mandriva[ ] GNU/Hurd [ ] Solaris/SPARC[ ] AIX     [ ]
      RaspberryPi   [ ] HPUX/PA  [ ] UnixWare     [ ] MacOS X [ ]
      OpenSTEP      [ ] HPUX/IA64[ ] OpenServer   [ ]  

Age         : ______________  Sex: ______________

Real name   : ___________________________________

E-mail      : ___________________________________

Address     : ___________________________________
		
              ___________________________________

City/ZIP    : ___________________________________

Country     : ___________________________________

Project(opt): http://____________________________

Setup and monthly payment by:

    Enclosed cash    [ ]
    Enclosed check   [ ]
    WesternUnion     [ ] MTCN ___________________________
    Bank transfer    [ ]
    PayPal payment   [ ] from ___________________________(e-mail)	
    TransferWise     [ ]
    Bitcoin payment  [ ]                                  
    Litecoin payment [ ] TXid ___________________________


IP choice       IPv4 [ ]     IPv6 [ ]
Please, note some servers support just one (like AIX for example)

By filling out this form, I agree with polarhome.com user policy:
http://www.polarhome.com/service/policy.html and I am aware that:

- I will lose my server account in any case of malicious activity
- personal information above are handled and kept confidentially
- setup and monthly payment fees are paid in advance
- polarhome realm and member hosts provide all services "AS IS"
- polarhome can not guarantee uninterruptible business continuity
- polarhome will refund payments in case of not delivered service


Date ________________ Signature _________________________________

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
This form has to be printed, filled, signed and sent by post to:

polarhome.com
c/o arpadffy
Edbovagen 47 
14263 Stockholm
Sweden

or alternatively by fax to: +1 772 325 8221 (US efax number) for
faster activation. Scanned images are also accepted, if e-mailed
to support@polarhome.com

General notes:
- text format application forms sent by e-mail are not accepted.
- form has to be filled out personally and signed by hand. 
- you should do it JUST if you agree with polarhome users policy.

Please, read FAQ at http://www.polarhome.com/service/policy.html

1. Enclosed cash
   - for this method of payment, please use just paper bank notes
   
2. Enclosed check
   - check should be payable to "Zoltan Arpadffy (polarhome.com)"
   - note: if the amount is less than 15 USD (the bank realisation  
     fee per check), then please, use some other payment method - 
     if you really want to contribute/donate.   

3. Western Union money transfer
   - the receiver should be: Zoltan Arpadffy - address above.
   - please, note the MTCN (Money Transfer Control Number)
   - you can find more information at http://www.westernunion.com

4. Bank transfer
   - amount should be transferred to:

	Zoltan Arpadffy
	for polarhome.com
	Bank: SEB, Stockholm, Sweden
	SWIFT: ESSE SE SS
	Account: 5231-0271578
   
   or with another words:
    
        Iban:  SE5150000000052310271578 
        Bic :  ESSESESS 

5. PayPal payment 
   - the payment should be sent to sponsor@polarhome.com
   - please, note your paypal e-mail address in the form
   - you can find more information at http://www.paypal.com

6. TransferWise payment
   - the payment should be sent to sponsor@polarhome.com
   - please, note your TransferWise e-mail address in the form
   - you can find more information at http://www.transferwise.com

7. Bitcoin payment
   - send to polarhome wallet: 1Lb6RBuBCaV2r3Q8RBGBZhiA5jDyMTNqrN  
   - please, note your last five characters of the transaction id
   - you can find more information at http://bitcoin.org/

8. Litecoin payment
   - send to polarhome wallet: LczkTakPFquCQa5UGbtHRpxd3TxrXQeBPY 
   - please, note your last five characters of the transaction id
   - you can find more information at http://litecoin.org/

If you have any question or suggestion regarding application form
or shell registartion process, you may ask support@polarhome.com



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