1.1. First Name
.....................*: |
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1.2. Last Name
......................*: |
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1.3. e-mail
address..................*: |
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1.4. Organization name
.................*: |
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1.5. Country (2 letter ISO
code).....*: |
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1.6. Street
Address..................*: |
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1.7. Street Address
2.................: |
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1.8.
City............................*: |
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1.9. State -
Region...................: |
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1.10. Postal
Code.....................: |
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1.11. TAX ID
Number...................: |
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1.12. Phone Number
[C][A][Nbr].......*: |
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1.13. Fax Number
[C][A][Nbr]..........: |
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1.14. For whom do you
plan to register domains with this account? (please mark all that
apply) *:
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1.15. Is person in charge
of payments same as above?
Yes
No
|
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