Bangladesh Telecommunications Company Limited
Registration Form for Domain Name under .bd
Please read the following note before filling out this form.
Note: All Domain Name Registration Fees must be paid in advance. By completing this registration form and
submitting it to us, you are agreeing to be bound by the terms and conditions set forth in the Registration
Agreement and the Domain Name Dispute Policy.
To make your registration process easy, please follow the steps below:
•
•
Review the Domain Name Registration Agreement and Domain Name Dispute Policy.
Have your Name Server Information ready.
Desired Domain Name
:
(without www part & in block letters)
REGISTRANT INFORMATION
Registrant Name
Address
City
State/Province (if applicable)
Postal/Zip Code
Country
Phone
Fax
Email Address
:
:
:
:
:
:
:
:
:
CONTACT INFORMATION
[A] Administrative Contact
.bd Handle (Registration Office)
Full Name
Title/Occupation
Organisation (if applicable)
Address
City
State/Province (if applicable)
Postal/Zip Code
Country
Phone and Fax
Email Address
Signature
:
:
:
:
:
:
:
:
:
:
:
:
Date
:
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[B] Technical Contact
If this information is the same as the Administrative Contact information, you may keep it
blank. Otherwise, please complete this section with the appropriate information.
Full Name
:
:
:
:
:
Title/Occupation
Organisation (if applicable)
Address
City
State/Province (if applicable)
Postal/Zip Code
:
:
:
:
Country
Phone and Fax
Email Address
Signature
Date
:
:
NAME SERVER INFORMATION
Please enter the Primary and Secondary Name Server information below. This information will be available
from the DNS/Web Site hosting company where you are going to host/already have hosted your web site. Please
contact them for the appropriate Hostnames and Network addresses. If you do not know your name server
information and want only reservation of the domain name applied for, you may update it later.
[a] Primary Domain Name Server
:
:
Host Name
Network Address
[b] Secondary Domain Name Server(s)
:
:
:
:
Host Name
Network Address
Host Name (optional)
Network Address (optional)
FOR OFFICIAL USE ONLY
Registration Information
Registration Number
Date
:
:
Signature of Authorized
Personnel
:
Date
:
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