This form is required to register a domain name in The ...
This form is required to register or modify a domain name in The Bahamas top-level Internet domain (.bs). A separate form should be completed for each domain name to be registered. Completed registration forms should be delivered to:
BSNIC
Office of Information Technology
University of The Bahamas
P.O. Box N4912
Nassau, Bahamas
The application may also be e-mailed to the following address: bsadmin@ub.edu.bs. Submission of this registration form signifies your agreement with the Terms and Conditions of Registration as published on the Web site register.bs .
|Requester: | |
|Application Date: | |
|Subject: | |
|Current E-Mail: | |
Type of Request: New Domain Modify Existing Domain Delete Domain
(Double-click the appropriate box to insert a check mark)
Complete Domain Name:
|Domain Registrant | |Technical Contact |
|Company: | | |Name (Last, First): | |
|Address: | | |Company: | |
|P.O. Box: | | |Address: | |
|City: | | |P.O. Box: | |
|State: | | |City: | |
|Postal Code | | |State: | |
|Country: | | |Postal Code/Zip: | |
|Classification: | | |Country: | |
|TIN: | | |Phone: | |
| | | |Fax: | |
| | | |E-Mail: | |
|Administrative Contact | |Billing Contact |
|Name (Last, First): | | |Name (Last, First): | |
|Company: | | |Company: | |
|Address: | | |Address: | |
|P.O. Box: | | |P.O. Box: | |
|City: | | |City: | |
|State: | | |State: | |
|Postal Code/Zip: | | |Postal Code/Zip: | |
|Country: | | |Country: | |
|Phone: | | |Phone: | |
|Fax: | | |Fax: | |
|E-Mail: | | |E-Mail: | |
|Primary Name Server |Hostname: | |IP Address: | |
|Secondary Name Server |Hostname: | |IP Address: | |
| |Hostname: | |IP Address: | |
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