PrimeGEN Internet Labs: InterNIC Registartion & Transfer Processing

GLOBAL CONNECT USA CANADA UK AUSTRALIA

Complete
Solutions
for the
Internet

	Use this form for new domain registration, domain transfer or delete domain processing.
	InterNIC charges $70 fee for first 2 years, applicable to all new domain registrations.
	For more information about InterNIC processing, please contact sales@primegen.com

Processing Type

New Domain Registration Domain Transfer Delete Domain

Select Domain Name

	Use Numbers or Alphabets
	No special characters ( except for " - " )
	Max length : 26 characters

www.

Domain Owner Information

Organization/Individual Name

Street Address

City, State, ZIP

Country

Administrative Contact Information

Person Name

Street Address

City, State, ZIP

Country

Phone Number

Fax Number ( Optional )

Valid E-Mail address

Billing Contact Information
Same as Administrative Contact

Person Name

Street Address

City, State, ZIP

Country

Phone Number

Fax Number ( Optional )

Valid E-Mail address

Domain Name Server Information

Important Note : Change these settings only if you have other valid DNS information.

Primary Domain Name Server

Primary DNS IP address

Secondary Domain Name Server

Secondary DNS IP address

Setting Higher Standards with ......

For More Information, please send mail to services@primegen.com .
Copyright � 1998 PrimeGEN Internet Labs