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New Member Registration

* If you are an organisation seeking new AfriNIC membership please use this form.

1. General Information

* Organisation Name:
* Activity Area:
* Membership Type: Member-Only End-User LIR
* General Address:
* City:
Postal Code:
* Country:
* E-mail:
* Phone:
Fax:

2. Billing Contact

Check if billing address is same as above
* First Name:
* Last Name:
* Billing Address:
* City:
Postal Code:
* Country:
* E-mail:
* Phone:

3. Admin / Tech Contacts

* Admin Nic-hdl:
Please enter your Admin's WHOIS nic-hdl
(Learn How to Create a Nic-hdl)
* Tech Nic-hdl:
Please enter your Tech's WHOIS nic-hdl
(Learn How to Create a Nic-hdl)

4. Additional Information

Existing IP addresses:
If you already have IP addresses where did you get them from?
APNIC ARIN RIPE NCC
LACNIC Upstream Provider
* RIR meeting:
Have you attended an RIR meeting?
Yes No
* Training:
When do you plan to train your staff on IP resource management?
Never 1 - 3 months 3 - 6 months 6 - 12 months > 12 months
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