PLEASE SUBMIT THE FOLLOWING TEMPLATE TO usdomreg at the
domain dimentech.com. We appologize for the way we've displayed our
email address but this helps limit the amount of SPAM we receive.

Sections or fields of this form marked with an asterisk (*) may be
copied as many times as necessary. (For example: If you had two phone
numbers for the Administrative Contact, you would use the same number
"6h" twice.  PLEASE DO NOT ALTER THIS APPLICATION IN ANY WAY.
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      1.   REGISTRATION TYPE
           (N)ew (M)odify (D)elete..:

      2.*  FULLY-QUALIFIED DOMAIN NAME:

      3.   ORGANIZATION INFORMATION
      3a.  Organization Name.....:
      3b.  Address Line 1........:
      3b.  Address Line 2........:
      3c.  City..................:
      3d.  State.................:
      3e.  Zip/Code..............:

      4.   DESCRIPTION OF ORG/DOMAIN:

      5.   Date Operational......:

      6.   ADMINISTRATIVE CONTACT OF ORG/DOMAIN
      6a.  NIChandle (if known)..:
      6b.  Whole Name............:
      6c.  Organization Name.....:
      6d.  Address Line 1........:
      6d.  Address Line 2........:
      6e.  City..................:
      6f.  State.................:
      6g.  Zip/Code..............:
      6h.* Voice Phone...........:
      6i.* Electronic Mailbox....:

      7.   TECHNICAL AND ZONE CONTACT
      7a.  NIChandle (if known)..:
      7b.  Whole Name............:
      7c.  Organization Name.....:
      7d.  Address Line 1........:
      7d.  Address Line 2........:
      7e.  City..................:
      7f.  State.................:
      7g.  Zip/Code..............:
      7h.* Voice Phone...........:
      7i.* Electronic Mailbox....:


      8.   PRIMARY SERVER: HOSTNAME, NETADDRESS
      8a.* Hostname..............:
      8b.* IP Address............:

      9. * SECONDARY SERVER: HOSTNAME, NETADDRESS
      9a.* Hostname..............:
      9b.* IP Address............:

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By submitting this request, you agree to comply with the following:

a. usTLD Dispute Resolution Policy and Rules
   http://www.nic.us/policies/docs/usdrp.pdf

b. The usTLD Nexus Requirements
   http://www.nic.us/policies/docs/ustld_nexus_requirements.pdf

c. Nexus dispute Policy and Rules
   http://www.nic.us/policiesdocs/nexus_dispute_policy.pdf

d. Registration Review Policy
   http://www.nic.us/policies/index.html

e. All data provided by you is, and will remain, true, correct, current
   and complete. Willful or grossly negligent provision of inaccurate
   or unreliable information, its willful or grossly negligent failure
   promptly to update information shall constitute a material breach of
   the Registration Agreement and may serve as the basis for cancellation
   of this registration.

By submitting this request, you understand that:

a. Registrant contact data will be made available through a publicly
   accessible WHOIS database.