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Application for Membership

Before completing the application form please read the notes below. If you have any questions, please email ccnsosecretariat@icann.org.

To: ccNSO Council

Date:

Re: Application for membership of the ccNSO

* APPLICANT: [Please read note 1 below and insert the name of the ccTLD manager]

* REPRESENTATIVE: [Please read note 2 below and insert the name of Applicant's representative]

* ccTLD NAME: [Please insert ccTLD name (for example .ak)]

With this letter, I, the Representative declare that the Applicant is the ccTLD manager (as defined in the ICANN bylaws, (Article IX Section (4)(1)) for the ccTLD name and wishes to apply for membership of the ccNSO and that I am duly authorized to make and sign this application for membership on behalf of the Applicant.

The Applicant hereby recognizes the role of the ccNSO within the ICANN structure, and agrees, for the duration of its membership in the ccNSO to:

(a) adhere to the rules of the ccNSO, including membership rules; and

(b) adhere to ICANN Bylaws as they apply to ccTLDs (Article IX and Annexes B and C of the ICANN bylaws.

The Applicant understands that:

(i) membership in the ccNSO is independent of any individual relationship a ccTLD manager has with ICANN or the ccTLD manager's receipt of IANA services. (Article IX Section (4)(3)); and

(ii) currently there are no fees payable for ccNSO membership. However, under the ICANN bylaws (Article IX Section (7) (3)), the ccNSO could in the future, subject to members approval, establish membership fees.

Signed by the Representative for and on behalf of the Applicant:

Contact Information: [Please read note 3 below and complete the information below]

Primary Contact Information:
* Name of Contact: [Please insert name]

* Address: [Please insert physical address of contact]

Telephone Number: [Please insert telephone number of contact]

* E-Mail Address: [Please insert email address of contact]

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Note 1 -- Who is the Applicant? Membership of the ccNSO is open to all ccTLD Managers. As defined in the ICANN bylaws (Article IX Section (4)(1)) a ccTLD Manager is the person or organisation referred to in the IANA database entry for a ccTLD under the current heading 'Sponsoring Organisation'.

Note 2 -- Who is the Representative?
Where the Sponsoring Organisation is listed in the IANA database as an individual person then that person is the Representative. Where the Sponsoring Organisation is listed in the IANA database as an organisation then the Representative is the individual person who is completing the application form for the organisation and is authorised to do so by the organisation.

Note 3 -- Who is the Primary Contact?
The Primary Contact (to be listed under 'Contact Information' at the end of this application form) is the main contact for the member and should be either the Administrative Contact or Technical Contact listed in the IANA database for the ccTLD.