Please note that you must copy the form below to an email or use the .sxw format above; do not fill it out directly on this wiki! Any applications made directly on the wiki will not be saved or recorded.
Note: An asterisk (*) indicates a required field
PERSONAL INFORMATION
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(Note: None of this information will ever be disclosed for any reason unless required by law)
*1. Please provide the following:
*First name
*Last name
Title [Mr/Ms/Mrs/Dr/Prof/Msgnr]
Sex [M/F/NA]
Affiliation:
URL / link to personal site:
*Street Address/P.O. Box #
*City
*Postal code
*Country
*Email
Fax
Phone
*2. Please describe yourself and your work. Be creative, we don't care what you did 10 years ago, we want
to know what makes you laugh, or cry, or jump. [< 200 words]
*3a. What Wikimedia communities (e.g. Commons, Wikipedia, Wiktionary, etc.)
are you involved in? What is your username there? When did you become involved with
each? Describe your involvement in one of these communities, briefly. [< 100 words]
*3b. (if 3a. doesn't apply). If you're not in any Wikimedia community, explain why
we should help you come to Wikimania. Sell yourself well. [< 100 words]
*4. Which of the following describe you?
[ ] Wikimedia Community member
[ ] Student
[ ] Researcher
[ ] Developer
[ ] Other (please specify)
CONFERENCE PARTICIPATION
------------------------
(Note: we do not need more speakers, so if you aren't one, that's more than ok.
If you are one, that's ok too.)
1. Have you already registered for the conference? [Yes/No]
2. Have you been accepted as a speaker/presenter for Wikimania already? [Yes/No]
3. Are you interested in giving a [5 minute] lightning presentation at the conference? If yes,
on which topic?
4a. If you came to Wikimania, would you be interested in attending hacking days
(A developers' event, August 1-3)? [Yes/No]
4b. If yes, what experience if any do you have with programming, and with
MediaWiki in particular?
TRAVEL PLANS
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*1. Origin of travel (city, country)
*2a. Planned date of arrival in Boston
*2b. Planned date of departure from Boston
*3. Do you need help obtaining a visa? [Yes/No]
*4. If yes, please provide your nationality :
STIPEND INFORMATION
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1. What kind of sponsorship do you require? Please tick one or more of the following choices (note:
prices can be found on the registration page at http://wm06reg.wikimedia.org)
[ ] conference pass
[ ] accommodation
[ ] partial airfare
[ ] airfare
2. If you are applying for airfare or partial airfare, please provide the amount you
require in US$. The fairer you are in your assessment of what you need, the
more people can come. And the less you ask for, the more likely you are to get
a scholarship.
3. If you receive a scholarship, you will be asked to write about your experience
during the conference, and you may be asked to give interviews. Is that ok with you?
[Yes/No] (if no: why?)
4. All scholarship recipients should make their own travel plans; reimbursements
will be issued upon arrival at the conference. Making your own arrangements often
results in better fares, and surer plans, and allows more people to benefit from the
scholarship fund.
If you *really* cannot make your own plans, please explain why here. We will take
this into consideration.
COMMENTS
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Please note anything else you want the organizers to know about your registration,
circumstance or any special needs. (< 200 words.)
