Managed DNS and Forwarding Service Sign Up
Domain Name
Organization Name
Address
City
State/Province
Postal Code
Country Code
 
Contact First Name
Contact Last Name
Voice Phone
Fax Phone
E-Mail Address
 
Select one service type:
Website/E-Mail Forwarding Service [$19 year]
Includes E-Mail forwarding and your choice of website forwarding, framed forwarding or coming soon web page. Forwarding options may be defined via online account maintenance after submitting this form.
Managed DNS [$19 year]
Managed DNS requires at least one static and unique IP address for your web site. The IP address is provided by your ISP or web hosting provider. More DNS zone information may be defined after submitting this form.
Default IP address to point domain to
 

Payment Information
Select payment type for your forwarding service or name service account. Note: If you choose to pay by check or other method, your account will not be activated until we receive payment.

Payment Type
Please complete the following information if paying by credit card.
Credit Card Number
Security Code What is the security code?
Expiration Date
Cardholder Name
For verification purposes, please provide the card holder name, billing address (street or box), and billing zip or postal code as shown on your credit card statement.
Card Billing Address
Card Billing Postal Code
 

Account Password
Specify a password that you will use to maintain your account information (6 to 16 characters).
    

Special Instructions
Please specify any additional information that you think we may need to process this request.
    

Promotion Code
If you were given a "Promotion Code", please enter it into the field below. If you do not have a promotion code, but were referred by someone, please list who referred you here, otherwise just leave the field blank.
    

Submit Your Request
Your application will be processed as soon as possible. You will be notified via e-mail after your account has been activated.

    

Please send any questions or comments regarding DNS Central services to email service@dnscentral.com or phone +1.949.698.7218 or postal mail to DNS Central P.O. Box 1131 Draper, UT 84020. Please report all system abuse to abuse@dnscentral.com. Copyright ©1998-2017 DNS Central. All Rights Reserved.