25 Oak
Rockland, ME 04841
Phone 594-8277
Fax 596-7248
Midcoast Internet Solutions
Registration Form
134B Back Meadow Rd.
Nobleboro, ME 04555
Phone 563-8563
Fax 563-3988
Please read our acceptable use policy before signing up for a new account.
There is also a printable form you can mail in with a check.
Choose one of the following account plans:

To signup online a $10 non-refundable startup fee will be charged to your credit card

Please Bill me for a full year so I can get a 10% discount

Switching from another local provider?
Provide a copy of a recent bill and we will waive the setup fee.
Billing Address
 Company Name : (If applicable)
         Name : 
      Address : 
  Town / City : 
State and Zip : 
A Phone number at which to reach you:
Home Phone :
Work Phone :
Selecting Username and Password

The username is an eight-letter or less name that other people use to identify you and is part of your email address. If you chose "carrots" for a username, your email address would be carrots@midcoast.com. The password should not be a dictionary word or a name, this protects others from compromising your account.
(use all lower case, see above)
**you can use up to 8 characters on Username and up 8 characters on Password**

Desired Username : 
Desired Password : 
Type of computer
(We no longer sign up windows 3.1 users)
(Mac Users need System 7.5.3 or greater)
How would you like to pay for the monthly membership?
***The ten dollar Startup fee will be billed to the Credit Card***
Credit Card Number : Credit Card Exp. date :
Credit Card Type: Visa MasterCard
How did you hear about us ?

Comment Area:

Note: Referral coupon must be submitted to have $20 credit apply.

I am 18 years of age or older. I have read and agree to the rules of Midcoast Internet Solutions' acceptable use policy.