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 DNS Record with your own custom CNAMEs, A Records, and MX Records. If you wish to create a Wild Card Only DNS Record, please click here. If you wish to have a standard zone file created with WWW, MAIL, FTP, all pointing to one IP, please click here.


Email Address:

Domain Name:(
hint: will create an Address Record and CNAME to

IP Address to point this Domain to:

Mail Server Address:(
Mail Server IP Address:

FTP Server Address:(
FTP Server IP Address:

Additional Vhost Record:(
Additional Vhost Record IP:

Additional Vhost Record:(
Additional Vhost Record IP:

Address of Master DNS Server:

Servers to have perform secondary DNS services for this domain:

MX (Mail Exchange) Records

Enter mx record as follows:(
MX 10
MX 20

Please enter the code on the right below

Last updated 5/5/04 Bella Mia, Inc. Copyright 1997-2014