Mail to:  confed@cnnic.net.cn

[#: Qualification Requesting Form of CNNIC Member]

1. Name of the network
   Name of the network (Chinese):
   Name of the network (English):
   Abbreviation of the network (English):
   Note:the abbreviation of the network may consist of English letters and " - "，no more than 25 letters.
2. Technical instruction
   The demand for the IP address in a year:
   The type of the applicant:
   The name of Upstream ISP:
   Access band width:
   Note: the name and the access band width of Upstream ISP could be showed in multiple lines
3. Applicant unit
   Name (Chinese):
   Name (English):
   Post address (Chinese):
   Post address (English):
   Post Code:
   WWW site:
4. Administration contact
   Name (Chinese):
   Name (English):
   Name of unit (Chinese):
   Name of Unit (English):
   Post address (Chinese):
   Post address (English):
   Post Code:
   Tel：
   Fax:
   E-mail:
5. Technical contact
   Name (Chinese):
   Name (English):
   Name of unit (Chinese):
   Name of Unit (English):
   Post address (Chinese):
   Post address (English):
   Post Code:
   Tel：
   Fax:
   E-mail:
6. Undertaker
   Name (Chinese):
   Name (English):
   Name of unit (Chinese):
   Name of Unit (English):
   Post address (Chinese):
   Post address (English):
   Post Code:
   Tel：
   Fax:
   E-mail:

[#: END]