******* Please DO NOT REMOVE Title ********
UK Domain Registration Template V1.4

This registration form should be used for UK domain names (.co.uk, .org.uk, .me.uk, .ltd.uk and .plc.uk) only. By submitting this form you agree to Servicecentre.co.uk Ltd's terms and conditions as listed on our web site at http://www.servicecentre.co.uk/reseller/ and those of Nominet UK, the Registry for .uk Internet Domain Names, at http://www.nic.uk/ref/terms.html. If you are a third party acting on behalf of the Registrant, by submitting this for you certify that you have informed the Registrant and have 
confirmed that they understand and have agreed to Servicecentre.co.uk Ltd's terms and conditions as listed on our web site at http://www.servicecentre.co.uk/tandcs.html and those of Nominet UK, the Registry for .uk Internet Domain Names, at http://www.nic.uk/ref/terms.html. 

(You may apply for more than one domain name per email by repeating the "Registrant's Details" section. Please do not alter, add or remove field names.)

(.co.uk, .org.uk, .me.uk, .ltd.uk and .plc.uk only)

Registrant's Details 
--------------------
Domain Name: 
Owner First Name: 
Owner Last Name: 
Owner Organisation: 
Company Registration No: 
Address (line 1): 
Address (line 2): 
City: 
County/Region: 
Postcode: 
Country: UK
Phone No: +44 (0) 
Fax No: +44 (0) 
Primary Nameserver Name: ns0.servicecentre.co.uk
Secondary Nameserver Name: ns1.servicecentre.co.uk

It is a requirement of Nominet UK that the name be registered in the end customer's name. 
The name will be registered to and owned by the name given in the "Owner First Name" and "Owner Last Name" field unless the "Owner Organisation" is given, in which case it will be registered to that company or business.

The company registration number is only required when registering .ltd.uk's and .plc.uk's.

Please give the domain name owner's address as fully as possible as Nominet will send the domain name certificate to this address.

Please change the nameserver details if you want to hold the name elsewhere. If you do not currently have these details at hand or if you are unsure of what to do, then please leave them as they are and we can change them later if necessary.



Reseller Details
----------------
Reseller ID: New Reseller
Business Name: 
Contact Name: 
Email Address: 
Address (line 1): 
Address (line 2): 
City: 
County: 
Postcode: 
Country: UK
Phone No: +44 (0) 
Fax No: +44 (0)
Special Instructions:

*** Please send the completed form to domains@servicecentre.co.uk ***
The details given here will be used for billing purposes.
If you require email forwarding or web space, please give the details in the "Special Instructions" field.
Please note that our terms are 7 days, after which time unpaid domains may be deleted without further notice.