Request form for .ac.uk domain registration

Before you complete this form, please check that you conform to the eligibility guidelines at www.ja.net/services/domain-name-registration/register.ac.uk/eligibility-ac.html

Completing this form correctly will speed up your application.

Your name:		Your name
Your email address:		Your email address
Please ensure that you enter a valid email address above, or we won't be able to reply to your message.
requested name:		[domain name requested]
to represent:		[the project, initiative or organisation for which the domain is being registered]
domain owner:		[the name of the proposed domain owner organisation]
descr:		[Provide information as required by section 1.9.3.1 of the eligibility guidelines:]
descr:		[Status of the organisation]
descr:		[Role and objective of the organisation]
descr:		[The status of staff within the organisation]
descr:		[The source of funding for the organisation]
descr:		[To whom the organisation is accountable]
descr:		[Purpose of domain name]

admin-c:		[Name of the admin contact]
address:		[full postal address of contact]
phone:		[telephone number of contact]
fax-no:		[fax number of contact]
e-mail:		[e-mail address of contact]

tech-c:		[Name of the technical contact]
address:		[full postal address of contact]
phone:		[telephone number of contact]
fax-no:		[fax number of contact]
e-mail:		[e-mail address of contact]

reg-c:		[Name and position within the domain owner organisation of the registrant contact]
address:		[full postal address of contact]
phone:		[telephone number of contact]
fax-no:		[fax number of contact]
e-mail:		[e-mail address of contact]

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