SHOUTcast Server Sign-Up Form

Thank you for signing up with FTC Internet's SHOUTcast hosting services.
Here's what you will be doing:

First, create your account on FTC Internet's SHOUTcast hosting network by filling in the form below.

Second, proceed to check-out to enter your billing information and select your payment type.

You have selected 96Kbps - 25 listeners

Now, lets get your contact information. In the form below enter the information that describes the person or company that will own the domain and/or the hosting account. Please give us the most accurate information so we can contact you from time to time if needed. This information will NEVER be sold and will only be used by FTC Internet to contact you concerning your account.

* = Required

First Name *
Last Name *
Valid Email *
Alternate Email
Company
Your Title
Address *
City *
State / Province *
Country *
Zip / Postal Code *
Home Telephone *
Work Telephone
Fax
Promo Code, if any.
How did you hear about us?
Detailed instructions, if any.
Website
Please choose a password that you will use to access your server account. If you do not choose a password, we will randomly generate one for you. Remember passwords are CaSe SeNsItIvE.
Password:
Confirm:
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