Valiant Internet Services Ltd

Name Server Modification Request Form

Please complete this form so we can undertake your request, Please ensure the security information is accurate to avoid delays or rejections. - We aim to process all requests within 24 hours.

1. Your Details ( Please complete ALL fields unless marked Optional )

Domain Name:
Your Full Name:
eMail Address:
Security Information
Your Username or Valiant A/C Ref:
Your Password or Last Invoice Number:

2. Your New NameServers ( Min. 2 required, Ask your new Hosting Provider if unsure. )

1st NameServer :			IP Address: *optional
2nd NameServer :			IP Address: *optional