Before you fill out this form, be sure you have choosen exactly which plan you would like.  After submitting this form, you will receive a receipt.  This does not mean we have processed your order. You will receive an email from our hosting team which will inform you of what is going to happen, how to finalize your order, and other pertinent information.

Account Information
Name
Domain name to be setup
Domain Registration New
Transfer
Plan Type
Plan Length
Hosted On
Special Instructions

Additional products such as disk space, domain pointers and mail options must be requested via e-mail.
Do you want MS FrontPage extensions loaded for this account?
Yes No
(Note: you must answer yes or no in order for Diskonnected to properly process your order.)

FrontPage Extensions are supported on NT and UNIX accounts, Diskonnected recommends NT to customers requiring Active Server Pages or Cold Fusion. If you are transferring a domain that is currently hosted on an NT account, Diskonnected recommends you select NT. All other customers should select UNIX servers.

Do you want Diskonnected to do the InterNIC action? Yes
No
Account Options
Please mark all options you would like for your account. This information is necessary to properly set up your account with Diskonnected.
Remember, you may only select options that are included in the plan you have selected above. Cold Fusion
Real Audio
Real Player
SQL
Web Statistics Program
Active Server Pages
SSL (Secure Socket Layer)
High Traffic
Cybercash
INTERNIC DOMAIN REGISTRATION INFORMATION:

note: The company information entered will be recognized as the domain name owner with InterNIC. This information cannot be changed without a new registration fee from InterNIC.

Company Information
Company Name
Street
City
State
Zip (Postal Code)
Country
Admin Contact Information
Name
Company
Street
City
State
Zip (Postal Code)
Country
Phone Number
Fax Number
E-Mail Address
NIC Handle if available
Billing Contact Information
Name
Company
Street
City
State
Zip (Postal Code)
Country
Phone Number
Fax Number
E-Mail Address
NIC Handle if available
Credit Card Information
Card Type
Card Number
Expiration
Name on Card

 



______________________________________________________________
maverick brewing company is the brainchild of michael j. capitain, iv esquire.
the maverick is the greatest car ever.  if you feel that this non-profit website and fake beer company
infringes on any copyright laws (it may, i just really dont know), please let me know.  if you know
how i can make this whole brewing company legal in the state of new york, please let me know. 
otherwise, have fun, drink safely, and rock it till the roof comes down.  peace.