Please fill out this form as completely as possible. The more information you give us the more likely we will be able to make an informed decision about your potential workshop attendance. If not enough information is given to make an informed decision your application will not be reviewed.

If you copy and paste from a word-processing program be careful to avoid pasting non-standard character in to the form fields.

Thank you and good luck!

1. Family Name (Last name, Surname)*
2. First Name*
3. Employer/Organization*
4. Position/Title*
5. Business Address
6. Business Telephone
7. Alternate Telephone
8. Email address*
9. URL
10. Fax
11. Date of birth (yyyy-mm-dd)
12. Country of Residence*
13. Name as it appears on passport or other travel document
    (Mandatory for International applicants)
14. Passport number
    (Mandatory for International applicants)
15. Country issuing passport
    (Mandatory for International applicants)
16. Date passport was issued (yyyy-mm-dd)
    (Mandatory for International applicants)
17. Date of passport expiration (yyyy-mm-dd)
    (Mandatory for International applicants)

1. Instructional track applied for*

   SS-E: Scalable Internet Services SI-E: Scalable Network Infrastructure NM-E: Network Monitoring & Management NM-F: Suivi et Gestion de Reseau (French version of English Track NM-E) AR-E: Advanced Routing Techniques CT-E: CERT (Computer Emergency Response Team)
2. Please indicate your specific interests within the area you have chosen*

1. Are you a UNIX user?*

   Yes No
2. How much have you used it?
3. Have you been a UNIX system administrator?*

   Yes No
4. Describe your experience (length of time, versions, etc.).
5. Have you used/administered TCP/IP networks?*

   Yes No
6. Describe.
7. Have you set up and/or administered any of the following? Please give details: Bind or any other Nameservers*
8. Mail Transport Agents (e.g. Sendmail, Exim, Postfix, Qmail)*
9. Mailing List Managers (e.g. Majordomo or other list manager)*
10. Web Systems/Servers (e.g. Apache, IIS or other web server)*
11. Have you configured or otherwise managed any of the following? Please give details. Routers*
12. Switches*
13. Network monitoring systems*
14. Network Operations Center (NOC)*
15. AR-E Workshop Applicants Only
    Please answer the following questions:
    a) Have you ever attended Scalable Network Infrastructure (SI-E) Track?(not mandatory, but preferred)
    
    
    b) List any Routing courses attended and name the training organization, e.t.c..?
    
    
    c) Previous OSFP experience.
    
    
    d) Any IS-IS experience?
    
    
    e) Previous BGP experience.
    
    
    f) Routing protocol experience.
    
16. CERT Workshop Applicants Only
    Please answer the following questions:
    a) Which area of security interests you?
    
    
    b) What security interventions have you experienced?
    
    
    c) How do you intend to use the knowledge gained at the workshop?
    

Role in National Networking Activities

Bear in mind that this information will be used to determine whether to admit you to the workshop, please provide details in the format of your choice.

Please be sure that it is sufficiently clear, well organized and adequate for this purpose.

1. 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*
2. 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.*
3. Scope of your institution (check all categories that apply)*

   Commercial Network Provider Academic Network Provider NGO Network Provider Other (specify)
4. Approximate number of full time staff at your institution*
5. How your training and current work prepare and qualify you for the track you wish to attend?*
6. How you expect to use the knowledge you gain at the workshop after you return to your country?*
7. If you have previously attended AfNOG or INET Workshops for Developing Countries Year and track you attended
8. A precise description of how you have used the training you have received in the past
9. The significant advances in networking which have occurred in your country specifically because of your knowledge and effort

The Workshop fee is US$2,500. This includes accommodation and meals. Applicants are usually expected to provide their own funding (from whatever sources). However AfNOG or its sponsors may make a limited financial assistance available to deserving candidates.

Financial Information

Even if you request financial assistance you might not receive any, and your acceptance into the Workshop will be conditional on your ability to provide all or most of the funding yourself. Although you may be well qualified and in great need of financial assistance, the maximum funds AfNOG or its sponsors may provide is US$1,000 in financial assistance for BOTH WORKSHOP FEES AND AIRFARE.

Payment for the workshop may be made by funds transfer, bank guaranteed cheque, or in cash. Further details will be provided in the admission letter to successful candidates.

NOTE: YOUR ACCEPTANCE INTO THE WORKSHOP MAY DEPEND ON YOUR ABILITY TO PROVIDE SOME OR ALL OF THE WORKSHOP FEES.

CERT WORKSHOP PARTICIPANTS ARE REQUIRED TO PAY FULL FEES

1. Are you are requesting financial aid from the AfNOG Workshop for attending the workshop and
   meetings, or for travel costs?*

   No, I do not request aid I request aid to help cover travel expenses. I request aid to help cover the attendance fees
2. Explain why you are asking for financial assistance. How will your organisation and your country benefit from your training? What other sources of funding have you approached, and what were the results?

3. If you are requesting financial support for travel expenses, please provide a good estimate of round trip, lowest economy excursion airfare between your place of residence and Kamapala, Uganda in May 2019

   1. Airfare ($)
   2. Airline
   3. Type of fare
   4. City of departure
   5. Source of your estimate
4. How will the finances be paid? Your Institution ($)
5. Your Government ($)
6. Your personal contribution ($)
7. Amount you ask from AfNOG in US Dollars (less than 1,000)*

Enter the name and contact details of two referees who can be contacted to verify information about you.

1. First Referee*
2. Second Referee*