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# Autonomous System (AS) Number Request Form #
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Document Name: afrinic-as Date: Jan. 2005
Version: 1.02
# MEMBER INFORMATION:
# Please enter an org_handle and the legal organisation name.
# In case you do not have an organisation handle but if you are still
# in the new-membership application process, please indicate below
# the ticket number of the relevant membership application requests.
org_id:
org_name:
new_member_ticket_number: (If you haven't received an org_id yet)
# REQUESTOR DETAILS
# # Please enter the details of the person in your organisation
# who is submitting this request. Also provide the technical
# contact of this AS number. You must provide a nic-hdl.
# To create a nic-hdl, please create a person object in
# AfriNIC Whois DB (for details please go to:
# http://www.afrinic.net/db/nic-hdl-howto.htm
name:
phone:
fax-no:
e-mail:
admin-c:
tech-c:
website:
# 4-BYTE OR 2-BYTE AS NUMBER ?
#
# Please indicate what length (in bytes) of AS Number
# you are requesting. (example, 2-byte or 4-byte). Please note
# that 4-byte ASNs are a new standard and that some equipment
# may need a firmware upgrade in order to support 4-byte ASNs.
# ADDRESS SPACE TO BE ANNOUNCED
#
# Please list the address prefixes that will originate from
# the new AS Number. Please specify each prefix in a
# separate "prefix" field below. Repeat "prefix" if necessary.
prefix:
#
# PENDING FIRST ALLOCATION TICKETS/REQUESTS:
#
# If the organisation wishing to be multi-homed does not
# have address space yet but has a pending request sent to
# <hostmaster@afrinic.net>, please include the ticket number
# of the request below.
pending_ticket_ID:
# AS NUMBERS AND CONTACT EMAIL ADDRESSES OF UPSTREAM PROVIDERS # # Provide the AS numbers and e-mail contact addresses of your upstream provider or peers.
AS_Number:
contact e-mail:
AS_Number:
contact e-mail:
# DATABASE TEMPLATE
#
# Please include database template(s) here so that the
# Hostmaster can register the assignment in the AFRINIC
# Database upon approval. If it is necessary to create a maintainer # object, please include that template too.
aut-num: ASNEW
as-name: *specify a name for the AS*
descr: *specify the name of the organisation*
org: *specify org ID here*
admin-c: *insert nic-handle of administrative contact*
tech-c: *insert nic-handle of technical contact*
mnt-by: AFRINIC-HM-MNT
changed: hostmaster@afrinic.net
source: AFRINIC
# ADDITIONAL COMMENTS:
#
# Please add any supplementary information that you think
# may facilitate the evaluation of this request below.
######################## END OF TEMPLATE ##########################
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