PRE-BOOK DOMAIN NAMES
You can use this form to have domain names added to our queue for registration as soon as they become available (April 24). You can view a complete list of domains here: http://www.neustar.us/registrars/fcfs/dotus_reservedlist_v2.zip
There is no extra cost for pre-booked domains, and you will NOT be billed UNLESS the domains are succesfully registered.
Domain Names:

(separate multiple domain names with spaces, commas and/or newlines)
Special instructions (if any):
Username:
Password:
Registrant's Name: 
Registrant type: 
Domain Usage: 
Length of term:
DNS Server #1 (if known)
DNS Server #2 (if known)
Administrative
Last Name:    First Name:    Title: 
Prefered Language    Company/Organisation: 
Email address: 
Second Email Address:
Job Title: 
Phone number:   Fax number:    Phone number #2: 
Address:
Unit Number:

   Street Name/Number:    Street Type: 
Office/Suite Number:     Postal/Zip Code:     City: 
State: 
Country:
Technical :
Same as Administative Contact
 Last Name:    First Name:    Title: 
Prefered Language:   Company/Organisation: 
Email address:
Second Email Address:
Job Title: (optional)
Phone number:    Fax number:    Phone number # 2: 
Address:
Unit Number:

   Street Name/Number:   Street Type: 
Office/Suite Number:    Postal/Zip Code:     City: 
State:
Country: CIRA Membership: 

All currency is in US dollars (if you are paying by check, money order, or electronic bill payment you may leave the following section blank).

Cardholders name:  Phone number:  Email: 
Billing Company:    
Billing Address:       City: Postal/Zip Code: 
Province/State:       Country: 
Card number:         
Credit Card Type:  
Expiry Date:            / 20
Credit Card Verification Code: (What is this?)
By clicking "Process Credit Card" below, you are affirming that you have read, understood, and agree to the Registrant Agreement.

All Major Credit Cards Accepted