Request for Primary DNS submission form

This form is to be used when Bella Mia will be performing DNS service for you. This will generate a Wild Card DNS Record ONLY. If you wish to specify DNS Records, please click here.


Name:

Email Address:
you@yourdomain.com

Domain Name:
yourdomain.com

IP Address to point this Domain to:

Address of Master DNS Server:

Servers to have perform secondary DNS services for this domain:


Please enter the code on the right below


Last updated 5/5/05 Bella Mia, Inc. Copyright 1997-2014