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.com.au Domain Name Application Form

The information supplied will be verified with relevant bodies. If any details are incomplete or inaccurate then the application will be declined. Once an application has been lodged, the information cannot be edited so it is vital that you are prepared with the correct details before submitting this application.

1. Application Information
1.1 Domain Name

Domain Name

 www. .com.au
2. Commercial Entity (licensee details)
2.1 Registered Business Name
Business Name
RBN (Registered Business Number)
State of registration
Owner Type
2.2 Australian Company Name
Name of Company
A.C.N. (Australian Company Number)
2.3 Other Commercial Entity
Name of Organisation
Type of Organisation
Registration Number
Explain "Other" organisation type in the box provided
3. Licensee Correspondence Postal Address
Street Address
Suburb/City
State
Postcode
4. Licensee Contact Person

Please Note:
The licensee contact person needs a NIC handle to be able to maintain domain name and contact information.

A. Enter an existing NIC handle
OR
B. Create a NIC handle
First Name
Surname
Position
Email address (must be current)
Telephone
Fax
5. Other com.au Names
Do you have any other com.au Names?
Please list other names in the space provided
Please provide reason for additional names in the space provided

Before you submit your application

Please check through the information on this form and ensure that it is correct and complete.
Once you have read and agree with the information you've entered, you must click the Submit button in order to have your Domain Name request processed.

If you do not press the Submit button your application will not be processed.