nrenum.net Delegation Request (form version 1.1)
-----------------------------

Please fill out the form below completely, and send a copy 
to delegations@nrenum.net. Please make sure you have read 
the current Charter, which is posted on the nrenum.net 
Website (http://nrenum.net). If you have any additional 
questions, please send an Email to info@nrenum.net or 
the trial mailinglist trial@lists.nrenum.net.

GENERAL INFORMATION

NREN/Organization: _____________________________________
Name: __________________________________________________
Address: _______________________________________________
________________________________________________________
________________________________________________________
Phone: _________________________________________________
Fax: ___________________________________________________
Email: _________________________________________________

What country are you representing?
________________________________________________________

Please specify the zone to be delegated, e.g. 1.4.nrenum.net
for Switzerland
________________________________________________________

TECHNICAL CONTACT

Name: __________________________________________________
Address: _______________________________________________
________________________________________________________
________________________________________________________
Phone: _________________________________________________
Fax: ___________________________________________________
Email: _________________________________________________

NAMESERVER

Please specify your nameservers, where the zone should be
delegated to (at least two (2))
________________________________________________________
________________________________________________________

REASON

What is the reason for not joining e164.arpa.?

[ ] Country code not delegated in e164.arpa.
[ ] e164.arpa. not operational
[ ] other reason, please specify: _______________________
    _____________________________________________________


What are the plans concerning e164.arpa in your country?
Is there a "roadmap" for starting an ENUM trial (or
commercial service) under e164.arpa.?
__________________________________________________________
__________________________________________________________


I/We hereby declare that all information provided above 
are correct. We further declare that we have read the 
trial charter, ad that we are going to comply with it.

At _____<Location>______________________________________
The ____<Date>__________________________________________

________________________________________________________
Name of technical contact