Kuwait Domain Operation Center

Domain Name Registration Form

 

Date:      /        /

 

KISR Handle Code:

(KDOC Use Only)

Operation:

*  New  

*  Modify 

*  Delete  

*  Renew 

*  Transfer

 

ISP Handle Code:

 

 

Domain Name:

(Please Print)

 

1. Applicant

1.1 Name:

1.2 Organization:

1.3 Address:

 

1.4 E-Mail Address:

1.5 Contact Numbers: - Phone:                              - Fax:                              - Mobile/Pager:

 

2. Administrative Contact

2.1 Name:

(If same as Applicant, Write: "Same as Applicant")

2.2 E-Mail Address:

2.3 Contact Numbers: - Phone:                               - Fax:                              - Mobile/Pager:

 

3. Technical Contact

4.1 Name:

4.2 Organization:

4.3    Address:

 

4.4 E-Mail Address:

4.5 Contact Numbers: - Phone:                                - Fax:                              - Mobile/Pager:

 

4. Name Servers

4.1 Primary:

Netaddress:

4.2 Secondary:

Netaddress:

4.3 Secondary:

Netaddress:

DNRF V2