Bangladesh Telecommunications Company Limited

Telejogajog Bhaban, 37/E, Eskaton Garden, Dhaka-1000.

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 Policy.
Have your Name Server Information ready.
Desired Domain Name
(without www part & in block
letters)

Registrant Information
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Registration 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 & Fax
Email Address

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Signature :

Date

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[B] Technical Contact

If this information is the same as the Administration 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 & Fax
Email Address

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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

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[b] Secondary Domain Name Server(s)

Host Name
Network Address
Host Name (optional)
Network Address (optional)

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FOR OFFICIAL USE ONLY

Registration Information
Registration number
Date

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Signature of Authorized
Personnel

Date

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