Domain Registration Please enable JavaScript in your browser to complete this form.Fields marked with an * are requiredIf you would like to apply for the domain registration, please fill in your details in this Form below and you will be automatically notified by our Representatives. Should our Agents/Representatives fail to reply to your request, please call us at our toll free number 1600.Please ensure that the fields marked in asterisk(*) are filled,ticked or chosen.CUSTOMER DETAILSFull Name *FirstMiddleLastContact no * Email Address *Address *The domain reservation/registration will be based on first come first serve basis and the minimum number of characters accepted is 3.Please tick the level of domain that you are applying for *2nd Level Domains(Ex. mydomain.bt)3rd Level Domains(Ex. mydomain.gov.bt/mydomain.com.bt/mydomain.edu.bt/mydomain.net.bt1st Preference *2nd Preference3rd PreferenceTechnical DetailsFull Name *Contact No *Email *Declarationa. I shall take full responsibility to backup, maintain and secure my website hosted at Bhutan Telecom.b. I understand that in the event of any security issues resulting from my website, Bhutan Telecom as the responsible hosting service provider in the interest of internet community will exercise full authority to suspend/terminate the website with or without prior notice.c. I have read and agree to domain name registration, acceptable user policy &other policies of Bhutan Telecom.d. Attach a copy of your trade license for business; CID for personal purpose; and undertaking letter from the Head of the Organization for official purpose. Upload License/CID or Letter of Undertaking * Click or drag files to this area to upload. You can upload up to 2 files. Scanned and signed Domain Registration Application Form * Click or drag files to this area to upload. You can upload up to 2 files. I AGREE TO THE TERMS & CONDITIONS ABOVE *SUBMIT Get in Touch with us (+975) 343434 Toll Free: 1600 Address: Drophen Lam 2/28, Chubachu Thimphu, Bhutan
