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New sTLD Application

Part B. Application Form

15 December 2003

Part A. Explanatory Notes | Part B. Application Form | Part C. Business Plan | Part D. Financial Model | Part E. Technical Specification | Part F. Application Checklist

 

Company Name ___________________________________________
Company Address 1 ___________________________________________
Company Address 2 ___________________________________________
Company City ___________________________________________
Company State/Province ___________________________________________
Company Postal Code ___________________________________________
Company Website Address http://_______________________________________
Company Country ___________________________________________
Company Contact Name ___________________________________________
Company Contact Email ___________________________________________
Company Contact Phone ___________________________________________
Company Contact Mobile ___________________________________________
Company Contact Fax ___________________________________________
Company Alternate Contact Name ___________________________________________
Company Alternate Contact Email ___________________________________________
Company Alternate Contact Phone ___________________________________________
Company Alternate Contact Mobile ___________________________________________
Company Alternate Contact Fax ___________________________________________
Sponsoring Organization Name ___________________________________________
Sponsoring Organization Address 1 ___________________________________________
Sponsoring Organization Address 2 ___________________________________________
Sponsoring Organization City ___________________________________________
Sponsoring Organization State/Province ___________________________________________
Sponsoring Organization Postal Code ___________________________________________
Sponsoring Organization Country ___________________________________________
Sponsoring Organization Website Address http://_______________________________________
Sponsoring Organization Contact Name ___________________________________________
Sponsoring Organization Contact Email ___________________________________________
Sponsoring Organization Contact Phone ___________________________________________
Sponsoring Organization Contact Mobile ___________________________________________
Sponsoring Organization Contact Fax ___________________________________________
Wire Transfer Receipt Number ___________________________________________

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