Domain Registration Policy

Domain Registration Form

Part 2.                              
Domain Name Owner:  
Organization/Person Name  
Street  
City  
State  
Country  
Administrative contact:  
NIC handle  
Name  
Organization Name  
Street  
City  
State  
Country  
Phone  
Fax  
Email  
Technical contact:  
NIC handle  
Name  
Organization Name  
Street  
City  
State  
Country  
Phone  
Fax  
Email  
DNS servers:  
Primary Server Hostname  
Primary Server Netaddress  
Secondary Server Hostname  
Secondary Server Netaddress