Host fee confirmation

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please confirm that you have sent the host fee to me through this form

Forum ID *

please specify your forum ID here

Contact email *

please specify your contact email here

Payment method *

specify the payment method you chose

Pay one month host fee in advance

Pay three month host fee in advance

Host fee you need to pay *

please specify what is the amount of your bill

Payement method *

please specify what is the method you used to pay host fee

Btc--16EK2Cg8eG51Q4yLTPiCysgeP7iUaUr4dE

Other:

Exchange ratio

please specify the exchange ratio you used if you pay me via btc

Transaction ID *

please specify your transaction of payment (both btc and paypal)

special statement

if you have any special statement, please specify here

Submit

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