Application Form of Membership of CNNIC IP A

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Application Form of Membership of CNNIC IP Address

Allocation Alliance

Instructions:

1.

Please read the instructions carefully; if you have any question, please contact “IP Group” via

010-58813000.

2.

Please fill in every item in details so that we can contact you.

3.

Please fill in the form using Red font .

4.

After each item of the form is filled in, please send the form as an attachment to our e-mail confed@cnnic.cn

for processing application.

Network Name

 Network Name (Chinese):

 Network Name (English):

 Abbreviation of Network Name (English):

Note: This item is of the most importance and it is not subject to change once decided. The abbreviation of

Network Name is a combination of English letters and “-” with no more than 25 letters. Sample: CSTNET.

【 Technical Instruction 】

Type of Applicant (ISP/ ICP/ IDC/others):

Name of Upstream ISP:

Access Bandwidth:

Note: The name and the access bandwidth of Upstream ISP may be showed in multiple lines. If the applicant has multiple identities, for example, as both an ISP and an ICP, please write in multiple lines.

【 Applicant 】

 Name (Chinese):

Name (English):

Postal Address (Chinese):

Postal Address (English):

Postcode:

【 Contact Person of Administration 】

 Name (Chinese):

Name (English):

Name of Applicant (Chinese):

Name of Applicant (English):

Postal Address (Chinese):

Postal Address (English):

Postcode:

Tel:

Fax:

E-mail:

Note: The contact person of administration refers to the contact person that signs an agreement, pays fees and conducts daily communication with CNNIC.

【 Contact Person of Technology 】

 Name (Chinese):

Name (English):

Name of Applicant (Chinese):

Name of Applicant (English):

Postal Address (Chinese):

Postal Address (English):

Postcode:

Tel:

Fax:

 E-mail:

【 Business License 】

Note: The scanned file (or electronic photo version) of the business license of the applicant shall be submitted together with Application Form of Membership of the Alliance

【 Application Instruction 】

 Profile of the applicant, including the name, the background and the main business, etc.

Size of network and scale of business:

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