AfPIF 2023 Registration Are you attending in-person or viewing the livestream? / Assisteriez-vous en présentiel ou virtuellement(Required) In-Person / en présentiel Livestream / virtuel Name(Required) Dr.Miss / Ms (Mlle)Mr. (M.)Mrs. (Mme)Prof.Rev. Prefix (Titre de civilité) First (Prénom) Last (Nom) Email(Required) Enter Email (Saisir votre email) Confirm Email (Confirmer votre email) Please use e-mail address associated with your Zoom account. / Veuillez utiliser l’adresse e-mail associée à votre compte Zoom. Do you have an Autonomous System Number (ASN) ? Avez-vous un numéro de système autonome (ASN)?(Required) Yes / Oui No / Non ASN(Required)Please Provide your Organisation’s Autonomous System Number (ASN) in ASPLAIN format (Digits Only). The ASN is verified with https://manrs.stoplight.io. Veuillez fournir le numéro de système autonome (ASN) de votre organisation au format ASPLAIN (Chiffres uniquement). L’ASN est vérifié avec https://manrs.stoplight.io. Company / Organization / Entreprise(Required) Organization Type / Type d’organisation(Required)SelectISPCDN/Content ProviderData Centre OperatorTelco/Mobile/Data ProviderIP Carrier/Transit ProviderIXP OperatorResearch and Education Network (NREN)Government Network OperatorGovernment Representative (Policy/Regulator)Internet Organization (RIR, ccTLD, etc)Submarine Cable OperatorVendorOther Role in Company or Organization / Rôle dans l’entreprise ou l’organisation Country / Pays(Required)– Please Select-Åland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Sint Eustatius and SabaBosnia And HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCôte d’IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People’s Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia (the former Yugoslav Republic of)MadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts And NevisSaint LuciaSaint Martin (French Part)Saint Pierre And MiquelonSaint Vincent And The GrenadinesSamoaSan MarinoSao Tome And PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia And The South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard And Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania, United Republic OfThailandTimor-LesteTogoTokelauTongaTrinidad And TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis And FutunaWestern SaharaYemenZambiaZimbabwe Mobile Number / Numéro de téléphone mobileNetwork/area code prefix + number. Max 15 characters. (Préfixe de l’indicatif de réseau/zone + numéro. 15 caractères maximum.) Do you need a Visa Invitation letter? / Avez-vous besoin d’une lettre d’invitation pour un visa(Required) Yes / Oui No / Non Please make sure the First and Last name fields at the beginning of the form correspond to your passport. / Veuillez vous assurer que les champs Prénom et Nom au début du formulaire correspondent à votre passeport. Passport Expiration Date / Date d’expiration du passeport(Required) DD slash MM slash YYYY Passport Number / Numéro de passeport(Required) Please enter your passport number Nationality / Nationalité(Required)– Please Select-Åland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Sint Eustatius and SabaBosnia And HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCôte d’IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People’s Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia (the former Yugoslav Republic of)MadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts And NevisSaint LuciaSaint Martin (French Part)Saint Pierre And MiquelonSaint Vincent And The GrenadinesSamoaSan MarinoSao Tome And PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia And The South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard And Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania, United Republic OfThailandTimor-LesteTogoTokelauTongaTrinidad And TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis And FutunaWestern SaharaYemenZambiaZimbabwe Place of Issue / Lieu d’émission(Required) I agree to include my information (First Name, Last Name, Organisation, Country, and ASN number) on the public AfPIF 2023 attendee list on the AfPIF website. J’accepte que mes informations (prénom, nom, organisation, pays et numéro ASN) figurent sur la liste publique des participants à AfPIF 2023 sur le site web d’AfPIF.(Required) Yes / Oui No / Non Dietary Requirements / Exigences diététiques(Required) No Dietary Restriction / Aucune restriction alimentaire Gluten-Free / Sans gluten Pescatarian / Pescataire Vegan / Végétalien Vegetarian / Végétarien Other Please let us know if you have a severe food allergy so we can take appropriate measures. Si vous souffrez d’une allergie alimentaire grave, veuillez nous en informer afin que nous puissions prendre les mesures qui s’imposent. Special Needs / Besoins spéciaux Would you like to Participate in the Peering Personals? / Souhaiteriez-vous participer aux Peering personnels?(Required) Yes / Oui No / Non I am not sure now / Je ne suis pas sûr(e) Will you be attending the Beers for Peers on Tuesday evening, August 22nd, 2023? Seriez-vous présent à la soirée “Beers for Peers” le mardi 22 août 2023?(Required) Yes / Oui No / Non I am not sure now / Je ne suis pas sûr(e) Will you be attending the Gala Dinner on Wednesday evening, August 23, 2023? / Participeriez-vous à la soirée de gala du mercredi 23 août 2023?(Required) Yes / Oui No / Non I am not sure now / Je ne suis pas sûr(e) Have you attended previous AfPIF events? / Avez-vous déjà participé à des événements d’AfPIF ?(Required) Yes / Oui No / Non How did you hear about AfPIF? / Comment avez-vous entendu parler d’AfPIF ? I agree to registration terms / J’accepte les conditions d’inscription(Required) I agree to pay the penalty of USD350, if I fail to attend the event after having registered, and without informing the event organizers at least 7 days prior to the event, meaning by Thursday 15th August 2023. J’accepte de payer une pénalité de 350 USD si je ne participe pas à l’événement après m’être inscrit(e) et sans avoir informé les organisateurs de l’événement au moins 7 jours avant l’événement, c’est-à-dire avant le jeudi 15 août 2023. Code of Conduct(Required) I agree to the Internet Society Code of Conduct. J’accepte le code de conduite de l’Internet Society By registering for this event, you acknowledge that the Internet Society will collect, use and otherwise process your personal data in accordance with its Privacy Notice. En vous inscrivant à cet événement, vous reconnaissez que l’Internet Society collectera, utilisera et traitera vos données personnelles conformément à son avis de confidentialité.