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 Chat Room Application Form

Chat Room Request : all fields must be completed

 What Name would you like to use for your Chat?

Chat Room Name no more than 30 letters

:
How would you rate your chat, G = general audiences, PG = parental guidance, R = restricted, MA = mature audiences, we don't to X so don't ask

 Please describe the Type of Chat Room you want to have on our server, This is a private chat server we reserve the right to refuse service to chats we believe are inappropriate.

 
Keywords for the search engines to find your chat page  ie: dogs, cats, muscle cars,

Tell us how to get in touch with you: Your name and email are required, your  phone number is not. your IP is logged when you send this form. 

We will send you an email with webchat-url and irc connection info as soon as your chat is ready

Name
E-mail
Country
Please contact me as soon as possible regarding this matter.