1997 Workshop Application Form
1997 Workshop Application Form

This form offers one way for you easily to apply for the 1997 Workshop for Developing Countries. Please note that this page only works if your browser supports forms.

You may also apply by completing a text version of the application form. For a copy of the Workshop announcement, including a blank application, send e-mail to: workshop-apply@isoc.org.

Please send your application electronically (via this form or email) if at all possible. The "Subject" line of the message should contain your surname or family name in the following format: INET'97 Workshop Application: your-family-name.

Completed applications may be submitted electronically by sending them in electronic mail form to workshop-application@isoc.org

If you are not able to send your application by electronic mail, please return this application by fax or air mail to:

Internet Society Network Technology Workshop
828 Guinda StreetA
Palo Alto, California 94301
U.S.A.

Voice: +1.415.322.0342 or +1.415.322.6728
Facsimile: +1.415.322.0342 or +1.415.325.0893


Personal Data:
Family/Last:               First:                    Middle: 
    
Home Address:      
                   
City:               
State or Province: 
Postal Code:       
Country:           
Telephone Number:   (please include country code) 

Position or Title:    Organization: 
Business Address:  
                   
City:               
State or Province: 
Postal Code:       
Country:           
Telephone Number:   (please include country code)
Fax Number:        
Email address:     

Date of Birth:     
Nationality:       
Name as it appears on passport or other travel document:
                   
Passport Number:   
Country Issuing Passport: 
Are you an ISOC member?:   Yes
ISOC Member Number (optional): 

Please rate your knowledge of English in these catagories:

Listening/comprehension:  minimal    fair    good    excellent
Reading:                  minimal    fair    good    excellent
Speaking:                 minimal    fair    good    excellent
Writing:                  minimal    fair    good    excellent
Course of Instruction
Instructional track applied for (select one track; the tracks will run concurrently)
            Track 1: Host-based Internetworking Technology
            Track 2: Backbone Internetworking Technology
            Track 3: Network Navigation and Services
            Track 4: National Network Management

Please indicate any specific intrests within the area you have chosen:

Technical Skills: (only for applicants to attend Tracks 1 and 2)
  1. Are you a UNIX user? How long have you used it?
  2. Have you been a UNIX system administrator? Describe your experience (length of time, versions, etc).
  3. Have you used/administered TCP/IP networks? Describe.
  4. Have you used or run a BBS? Describe.
  5. Have you set up UUCP? How many times? Describe.
  6. Have you set up modem initialization strings? In what circumstances? How often?
  7. What other operating systems are you familiar with (eg MacOS, AppleTalk, MS-DOS, Novell Netware, Banyan Vines, VMS, DECNET, etc.) and how long have you been a user or administrator of each?
  8. Have you configured and operated a Domain Name System server? How many zones?
  9. Have you configured routing on either dedicated router hardware or a UNIX host? Which manufacturers/models/software versions and protocals?
Internet Experience: (only for applicants to attend track 3)
  1. Do you have experience in using the following Internet services? (Please qualify your experience using 0 to 5, 0 means no experience and 5 a lot of expertise)
         Listserver
         News
         FTP
         Gopher
         Web
         Other (specify):
    
  2. Do you have experience running Internet services? (Please qualify your experience using 0 to 5, 0 means no experience and 5 a lot of expertise)
         Listserver
         News server
         FTP server
         Gopher server
         Web server
         Searching/Indexing services
         Caching Server
         Other (specify):
    
Description of Role in National Networking Activities

Bearing in mind that this information will be used to determine whether to admit you to the workshop, please provide in the format of your choice the following information about yourself. Please be sure that it is sufficiently clear, well organized and adequate for this purpose.

  1. A summary of your educational and professional background.
  2. A description of your current employer, your position, your duties and responsibilities, and how they relate to current and future data networking activities in your country.
  3. A brief description of your computing and networking environment (operating systems, networking software, modems, etc.), including the connectivity of your organization to the Internet and your country's connectivity to the international Internet.
    1. Scope of your institution (check all categories that apply):
            Academic
            General Research
            Government
            NGO
            International organizations
               (UNESCO, UNDP, World Bank, etc.)
            Commercial
            Internet Provider
            National Network Support
            Special Interest Group          Specify 
            Other                           Specify  
      
    2. Approximate number of full time staff at your institution:
  4. How your training and current work prepare and qualify you for the track you wish to attend.
  5. How you expect to use the knowledge you gain at the workshop and the INET'97 conference after you return to your country.
  6. If you have previously attended Internet Society Workshops for Developing Countries,
    1. Year and track you attended:
    2. A precise description of how you have used the training you have received in the past:
    3. The significant advances in networking which have occurred in your country specifically because of your knowledge and effort:

Financial Information Your application must contain the following complete information if you wish to be considered for financial support to attend the workshop. Your acceptance into the workshop may depend on your ability to provide some or all of the funding.

  1. Are you are requesting financial aid from the Internet Society (ISOC) for attending the workshop and conference? Yes No
  2. If you are requesting financial aid, please provide a complete list of funding sources in the following form. The list should contain all sources of funds that are available to you for payment of the workshop fee.
    1. Your Institution U.S.$
    2. Your Government $
    3. From international organizations $
    4. Your personal contribution $
    5. Amount you ask from ISOC $
      TOTAL COST $3,000.00
  3. Will you provide your own airfare? Yes No
  4. If you are requesting financial support for airfare, please provide a good estimate of round trip, lowest economy excursion airfare next June between your place of residence and Kuala Lumpur, Malaysia.
    1. Airfare:
    2. Airline:
    3. Type of fare:
    4. City of departure:
    5. Source of your estimate: