Financial Assistance Request

Name: * REQUIRED
Last Name: * REQUIRED
Organization: * REQUIRED

(Use PRIVATE if not representing any Organization)

Position:
E-mail: * REQUIRED
Phone Number: * REQUIRED
Gender: Male      Female * REQUIRED
Language: Spanish      Portugues      English * REQUIRED
Address: * REQUIRED
City: * REQUIRED
Country: * REQUIRED

 

Define your organization:

  • ISP (Internet Service Provider)
  • Academic
  • Governmental
  • Civil Society
  • Other

Is your organization member of LACNIC?

Yes      No

Is this your first time to attend a LACNIC meeting?

Yes      No

Have you ever requested a scholarship from LACNIC to attend the meeting?

Yes      No

Have you ever received a scholarship from LACNIC to attend the meeting?

Yes      No

When?

  • Previous Events
  • LACNIC X (2007 - ISLA MARGARITA, VENEZUELA)
  • LACNIC XI (2008 - SALVADOR / BAHIA, BRASIL)
  • LACNIC XI (2009 - PANAMA CITY, PANAMA)

Are you willing to contribute to any of the meeting sessions (e.g. make a presentation, paper, etc.)?

Yes      No

Comments:

 

Type of assistance requested (Select a maximum of 2, setting priorities)

Note: If your organization is a member of LACNIC, registration fees, lunches and social event for 2 people from each organization will be paid by LACNIC.

  • Free registration to all the event's sessions, social event and lunches that LACNIC will offer to participants
    Priority 1      Priority 2

  • Financial assistance for accommodation expenses at the meeting’s hotel
    Priority 1      Priority 2

  • Financial assistance for airfare to Curaçao
    Priority 1      Priority 2  (airport taxes, visa applications and other requirements such as immunizations are responsibility of the selected candidates)

 

Comments:

The applicants who are selected will be informed of this decision by March 18, 2010. Confirmation of acceptance of the financial assistance by the selected applicants is due on April 5th, 2010.
Applications received after the due date will not be considered.
For additional information, please contact becas@lacnic.net

 

LACNIC 2010
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