>> Indian Domain Registration :

		Form for Internet Domain Registration under .IN (India)

				Issued : Sep 2000

Please do not alter this application form in any way. 
Please note that the fields marked * are essential. 

Complete and Send this template to domains@zebraserver.com.

After receiving the email, we will send you necessary details
related to payment and list of documents required. 

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1 Domain Name Information 

1.1 Registration Type 
    (Mention N for new domain, M for modification in existing domain or D for 
     deleting an existing domain)

	Type *		:


1.2 Fully Qualified Domain Name 
    (Currently we allot the following sub-domains
 	co.in  	--      For Registered Companies/Trademarks/Banks
	firm.in -- 	For Proprietary Concerns/Partnership
                 Firms/Shops/Liaison Offices
        ac.in  	--      For Academic Community
        res.in  --      For Research Institutes
        gov.in  --      For Government Organisations
	mil.in  --	For Military Establishments
        net.in  --      For Internet Service Providers
	in  	--      For Internet Service Providers
	org.in  --	For Non-profit Organisations
	ind.in	--	For Individuals
	gen.in	--	For General/Miscellaneous Purpose
                   	
     
	Mention the domain name that you would like to register.
     	eg:        your_company_name.co.in, etc)

	Domain Name *   :


2 General Details
 
2.1 Name of Organisation/Entity
 
	Name *		:

 
2.2 Description of Organisation/Trademark/Domain
  
	Description	:


2.3 Address of Organisation/Entity

	Address Line 1 *:
	Address Line 2	:
	City *		:
	State *		:
	Pin Code *	:
	Country	*	:


3 Contact Details

3.1 Your E-Mail Address

	E-Mail Address *:


3.2 Administrative Contact (from your organisation only) 
 
	Name *          :
	Designation     :
	Address Line 1 *:
	Address Line 2  :
	City *          :
	State *         :
	Pin Code *      :
	Country *       :
	E-Mail Address *:
	Phone Number    :
	Fax Number      :


3.3 Billing Contact

	Name *          :
	Designation     :
	Address Line 1 *:
	Address Line 2  :
	City *          :
	State *         :
	Pin Code *      :
	Country *       :
	E-Mail Address *:
	Phone Number    :
	Fax Number      :          

 
3.4 Technical Contact
   
	Name *		:
	Designation	:
	Address Line 1 *:
	Address Line 2	:
	City *		:
	State *		:
	Pin Code *	:
	Country	*	:
	E-Mail Address *:
	Phone Number	:
	Fax Number	:




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