1. Account Type:

Please choose one of the following:

New DNS Service

Migrating DNS from existing provider

Existing AT&T Customer changing to DSL Product

2. Service Address:

Domain Name:

End User Contact:

AT&T DSL Customer Tracking Number:

Company Name:

Address:

City/State/Zip:

County/Country/Post Code
(Non U.S.):

Telephone:

Fax Number:

E-Mail:

3. DNS Service:

Please enter the range of IP addresses assigned to you by AT&T.

First:

Last:

4. Please list your DNS host records and the IP address assigned to each.

Host Name:

IP Address:

:

:

:

:

:

:

5. If you have more than one mail record, please list them in order of their preference, 10 being the first preference:

10:

20:

30:

6. Special Instructions: