Manic Web Design & Hosting Account Signup

Choose a basic service type:

New Domain Account - http://www.yourdomain.com/ or http://yourdomain.com: $50 setup, $25/month
E-Commerce Account - http://www.yourdomain.com/ or http://yourdomain.com: $100 setup, $60/month

URL:

If you need us to register a domain name for you, enter the desired name. Please make sure that the domain name is available. You can check with our domain locator to find out. The cost of registration is $60.00/2 years

http://www.

Additional services

You can set up email accounts, email aliases, and other email forwarding options from the Account Control Panel once your account is setup.

Account password:

Keep this password in a safe place. You will need it to use your account!
6 to 24 characters.

(again to confirm)

Administrative Contact

The administrative contact is the person who will hold ownership of the account.

* fields are optional

Name:
* Company:
Address:
*
City:
State:
Zip:
* Country:
Phone:
* Fax:
Email:	(You must provide an email contact. You may change this at any time)

How often would you like to pay?
Payments must be made with personal or business checks, or money orders in US Funds. Your first month will be pro-rated and charged immediately. For your convenience, we offer quarterly, semiannual, and annual plans. All payments are based on quarterly charges.
Quarterly
Annually (we waive the setup fee!)

Where did you hear about Manic?

Banner Advertisement
Yellow Pages
Web Site
Please specify the website:

Referral
Please let us know who referred you: