VI Domain Form

Domain Name*

valid domain names may end in .vi, .com.vi, .net.vi, .org.vi, .co.vi, .k12.vi

Organization Using Domain Name

Requester's Email*

Organization name (registrant)*

Organization Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Administrative Contact

Administrative Organization:*

Name*

First Last

Address:*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone:*

Fax:

Email:*

Enter Email Confirm Email

Technical Contact

Same as Admin Contact

Yes

Technical Organization

Name*

First Last

Address:*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone:*

Fax:

Email:*

Enter Email Confirm Email

Billing Contact

Same as Admin Contact

Yes

Billing Organization

Name*

First Last

Address:*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone:*

Fax:

Email:*

Enter Email Confirm Email

Primary Name Server

Primary Server Hostname:*

This is the host name you wish to use as your primary name server. For example: ns1.yourdomain.vi.

Secondary Name Server

Secondary Server Hostname:*

This is the host name you wish to use as your secondary name server. ns2.yourdomain.vi.

Comments:

I have read, understand and agree to the Domain Rules and Dispute Policy*

Yes

Domain Registration Form

Organization Using Domain Name

Administrative Contact

Technical Contact

Billing Contact

Primary Name Server

Secondary Name Server