2016 Youth Internet Governance Forum Taipei

Application Form
Notes:
1.

2.

The provision of personal data and other related information by means of the
application form is voluntary and will be used to determine the application. Please
ensure data provided is adequate and accurate.
Your application must reach the Secretariat by April 30, 2016 by sending it to
2016aprigf@nii.org.tw.

Personal Information
Applicant Name

Sex
Age

Nationality

Mobile Phone

School/University & Faculty

Email

Year

Major

Correspondence Address

Photocopy of Your Student ID

2016 Youth Internet Governance Forum Taipei

Application Form
Are you available to fully participate in the program from 26 29 July 2016?
If not, please state the reason.

Please state the reason(s) why you wish to participate and what you wish to
experience from this forum: (Within 200 words)

What is the Internet Governance Issue you concern most? (Within 200 words)

I hereby declare that all information provided is true and correct.

Applicant Name & Signature

Date