*************************NB!!!!**************************** *Please view http://www.coza.net.za/ect before completing this form.* ********************************************************************* *** DO NOT DELETE or ALTER ANY OF THE FOLLOWING TEXT *** UNIFORUM S.A. COZA Registration Office Last Change - 01 February 2008 APPLICATION TO ESTABLISH A SUB-DOMAIN WITHIN THE .CO.ZA NAMESPACE OF THE INTERNET. =================================================================== |UniForum S.A. has administered the '.CO.ZA.' namespace as from | |the 15th October, 1995. | | | | ** TERMS AND CONDITIONS AND POLICIES OF REGISTRATION ** | |.CO.ZA Domain registrations are subject to the terms and condi- | |tions as published at http://www.coza.net.za from time to time. | | | | ** COSTS OF REGISTRATION ** | |.CO.ZA Domain registrations are subject to charges as published | |at http://www.coza.net.za from time to time. | | | | ** DOCUMENT INSTRUCTIONS ** | |This document is scanned electronically so please observe | |instructions regarding the document format. Do not uuencode or | |send it in base64 format. Do not edit this document with a | |word processor that does not leave this form in plain ascii text.| | | |Please send only ONE APPLICATION per electronic mail. | | | |If you do not understand something, please refer to the faq | |or contact UniForum SA's office, the details of which are | |available at http://www.coza.net.za | | | |Please Email the completed form once the domain is ready to: | | coza-admin@co.za | |Please send any other queries to: support@co.za | |Use the 'coza-admin' email ONLY FOR COMPLETED FORMS. | | | | ** VAT AND INVOICING ** | |IMPORTANT NOTICE: All tax invoices pursuant to this application | |form will be sent electronically. By submitting this form to | |UniForum SA the designated Billing Contact (line 2f) hereby | |irrevocably agrees and confirms that it is both willing and | |able to receive tax invoices in this format. | =================================================================== 1. DOMAIN NAME and ACTION Give the name of the subdomain. This is the name that will be used in tables and lists associating the domain with the name server and IP addresses. The .co.za domain names that are delegated by UniForum S.A. are at the third level, for example: thisnetwork.co.za. Domain names in the CO.ZA zone are limited to 30 characters. The Action field specifies whether this is a 'N'ew application, an 'U'pdate or a 'D'eletion. 1a. Complete domain name: joburgattitude.co.za 1b. Action - [N]ew, [U]pdate, or [D]elete : U 2. DOMAIN REGISTRANT and BILLING The name and postal address of the domain registrant. (Postal address and Street address, delimited with commas, on a single line please). Invoices are sent electronically. 2a. Domain Registrant: Schalk Lourens 2b. Registrant Postal address: Postnet Suite 541, Private Bag X29, Gallo Manor, 2052 2c. Registrant Street address: Postnet Suite 541, Private Bag X29, Gallo Manor, 2052 2e. [I]nvoice or [A]ccount (Default I): I 2f. Organisation to be billed or account no. : Ernic Innovative Technologies 2g. Email to send invoices to: erhard@ernic.co.za Item 2i must contain the Postal Address for Tax Invoicing purposes. 2i. Invoice Addr: P.O.Box 51627, Wierda Park, 0157 2j. Registrant Phone No.: +27.716758354 2k. Registrant Fax No. : 2l. Registrant e-mail : cicero7520@yahoo.co.za 2n. VAT No. for 2f : 3. CNAME - This section is no longer in use Should you be updating information other than the CNAME information for a current CNAME registration, leave the following three fields exactly the same as the current registration (Details can be found at http://whois.co.za/whois.shtml). If you are migrating a CNAME registration to a Nameserver registration (Section 6) leave the following blank. 3b. Full CNAME : 3c. Sub alias 1: 3d. Sub alias 2: 4. ADMINISTRATIVE CONTACT It is necessary to provide details of a person who deals with the administrative matters of the registrant for .co.za domains. (Postal address, delimited by comma's, on a single line please) (Phone and Fax numbers in International form - ie +27 11 314 0077) 4a. Name (last, first): Smit, Erhard 4b. Title/position: Webmaster 4c. Organisation: Ernic Innovative Technologies 4d. Postal Addr: P.O.Box 51627, Wierda Park, 0149 4e. Phone Number: +27.836564309 4f. Fax Number: +27.866621668 4g. Email: erhard@ernic.co.za 5. TECHNICAL CONTACT It is necessary to provide details of a person who deals with the technical matters of the registrant for .co.za domains. (Postal address, delimited by comma's, on a single line please) (Phone and Fax numbers in International form - ie +27 11 314 0077) 5a. Name (last, first): Smit, Erhard 5b. Title/position: Webmaster 5c. Organisation: Ernic Innovative Technologies 5d. Postal Addr: P.O.Box 51627, Wierda Park, 0149 5e. Phone Number: +27.836564309 5f. Fax Number: +27.866621668 5g. Email: erhard@ernic.co.za 6. NAMESERVERS FOR THIS DOMAIN Domain administrators should provide at least two independent nameserver hosts for the requested domain. Please ensure that the servers are in physically separate locations and on different sections of the Internet. Nameserver records only require glue address records when the nameserver is a child of the domain being registered. Any glue address records that are provided for nameservers that are not a child of the domain being registered will be ignored. More than one glue address record may be specified for a single nameserver record as a comma delimited list. All nameservers should be operational before submitting this application. There is a limit of five nameservers for the .co.za zone. 'FQDN' is the Fully Qualified Domain Name of the host. *** IF YOU DO NOT KNOW SOMETHING - ASK YOUR ISP *** 6a. Primary server FQDN: ns1.ernicnet.co.za 6b. Primary server IPv4 glue: 6c. Primary server IPv6 glue: 6e. Secondary server FQDN: ns2.ernicnet.co.za 6f. Secondary server IPv4 glue: 6g. Secondary server IPv6 glue: 6i. Secondary server FQDN: 6j. Secondary server IPv4 glue: 6k. Secondary server IPv6 glue: 6m. Secondary server FQDN: 6n. Secondary server IPv4 glue: 6o. Secondary server IPv6 glue: 6q. Secondary server FQDN: 6r. Secondary server IPv4 glue: 6s. Secondary server IPv6 glue: 7 AND 8 - these sections are no longer in use. 9. PLEASE DESCRIBE YOUR ORGANISATION BRIEFLY. Information NOT on a labelled line will be ignored. 9a. : IT Services 9b. : 9c. : 9d. : 9e. : 9f. : 10. DOMICILIUM CITANDI ET EXECUTANDI The organisation specified in 2 above chooses as its address for the giving and serving of notices the following street address. Box numbers are not acceptable. (This could be the same as 2c. above). ....................................... ....................................... ....................................... .......................................