CONTACT TEMPLATE FOR .INT DOMAIN NAMES

Domain Name.....................: 

Organization Name...............:
     Address(a).................: 
     Address(b).................: 
     Address(c).................: 
     Address(d).................: 

Organization (Admin) Contact....: 
     Email......................: 
     Phone......................:  
     FAX........................: 

Primary Technical Contact Name..: 
     Organization...............:
     Post Address...............:
     Email......................:
     Phone......................:
     FAX........................:	

Secondary Technical Contact Name: 
     Email......................:
     Phone......................:
     FAX........................:
		
Nameservers:
      Primary...................:
      IP Address................:

      Secondary.................:	
      IP Address................: