Registrar support contact Registrar support email Official name of consenting municipality Name of municipal representative Must be the Mayor, a department head, chief operating officer, chief administrative officer or equivalent for the municipality. Title of municipal representative Email Contact email for the municipal representative Phone Contact phone number for the municipal representative Domain name Official name of applicant municipality Authorization of Municipal Representative I certify that I am the authorized representative for the consenting municipality identified above; I have knowledge of the facts set out in this certificate; and the consenting municipality has consented to the registration of the domain name by the applicant municipality. Date Leave this field blank