Create A Web Hosting Subscription

Hosting Subscription Signup

Looking to set up a fresh private web hosting account for the website recently constructed by BrainScanMedia.com, Inc.? You're in luck! Simply complete the form below to submit your account creation request to us. Upon receipt and processing of your request, we will promptly inform you when your account is prepared. Please allow for a response time of up to 24 hours. Please be aware that your credit card will not be charged until your account setup is complete.


Hosting Package
Total Cost: $0.00
Email Address Setup
At this time, we do not provide email account services directly. All email accounts are established through an external email service, which is distinct from BSM and involves separate billing. If you wish to use your own service, please indicate your preference in the dropdown menu above.
Email Forwarding List
Please provide a list of the email addresses you would like to set up based on the setup type you selected above. Please list each email address on a separate line. If you require forwarding, please list email address and forwarding address. Example: name@yourdomain.com > name@gmail.com
Payment Information
Billing Information