Thank you for signing up for SevereStreaming.

All data entered in these fields will be kept private and will only be used to help set up your stream and for technical support.

By submitting this form, you agree to the Terms of Service and acknowledge that this service is meant for entertainment purposes only.

*** PLEASE ENTER YOUR USERNAME AS firstname.lastname (example: kory.hartman). IT WILL BE THE USERNAME FOR YOUR WINDOWS MEDIA ACCOUNT AS WELL! ***

Thank You.

Account information

Username: *

Your preferred username; punctuation is not allowed except for periods, hyphens, and underscores.

E-mail address: *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Personal Information

First Name: *

Your First Name

Middle Name:

Your Middle Name (Optional)

Last Name: *

Your Last Name

Address: *

Your Street Address (including Apartment number, if applicable)

City: *

Your City

State: *

Your State (In Abbreviated Form - Example: SD)

Country: *

Your Country

Zip Code: *

Your Zip (Postal) Code

Phone Number: *

Your Phone Number (Complete with Area Code) -- Preferably a cell phone where you can be reached while chasing.

Email Address: *

Your Email Address -- Can be different that the one above. This is where specific streaming instructions and tech support bulletins will be sent.

Website:

Your Chasing-related Website (if applicable). Enter with http:// included!

Media Contact Info:

Phone Number and/or Email Address for Media to Contact You, If Desired

Service Level

Service Level: * Basic - FreePersonal - $15.00/mo. DonationPrivate - $30.00/mo. DonationPremier - $45.00/mo. Donation

The SevereStreaming service level you are requesting.

Technology

Computer Model: *

Brand and Model of the computer with which you plan to stream. (example: Dell Latitude D810)

Operating System: *

The Operating System of the computer with which you plan to stream. (example: Windows XP)

Processor Brand and Speed: *

Brand and Speed of the main processor in your streaming computer. (example: "Intel Core Duo @ 2.0 GHz")

Amount of RAM: *

The amount of RAM Memory in your streaming computer. (examples: 512KB, 2GB)

Mobile ISP: *

The Internet Service Provider you use while chasing. (examples: "Sprint", "Alltel")

Type of Mobile Data: *

Type of data connection you use while chasing. (example: Cellular, Satellite)

Data Hardware: *

Model and Type of hardware used to access the internet. (examples: "Verizon 5740 card", "Alltel UM-150 USB", "Tether through Motorola E815")

Video Camera: *

Brand and Model of video camera you plan to use for streaming. (example: "Sony TRV-950", "Logitech WebCam Pro")

Camera Interface: *

How the video camera connects to your streaming computer. (examples: "Firewire", "USB")