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Domain Name
ORGANIZATION
Company Name
Company Registration No.
Required for .com.my and other countries' domain registration. Not necessary for .com and other international domain name registration.
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
Fax Number

Area Code Phone Number

PRIMARY CONTACT PERSON
Full Name *

First Name Last Name
E-mail *
Mobile Number *
Normally is the primary contact person for your company. You may assign your account / admin staff or other personas the secondary contact as below. You will have the right to login to view and update your company's billing info and view latest or passed invoices while secondary contact will recieve additional copy of invoices sent.

** Please fill in same contact name but with different email address under secondary contact info if you don't intend to assign other person to manage or follow up on your invoices. This is incase invoices didn't reach your primary email address, it will still reach secondary email address.
SECONDARY CONTACT PERSON
Full Name *

First Name Last Name
E-mail *
example@example.com
Mobile Number

Use these info as my billing contact info
** If registration info is different from billing info, please sign up for the billing contact info.
YES NO
Should be Empty:

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