This is a sample EoI Form for viewing only. <Edit Contents> button is disabled. If you plan to fill out an EoI, please contact firstname.lastname@example.org.
This EoI Form contains Profile Sections (A-C) and a separate Application Section (D) for this At-Large Board Member Selection cycle.
Please use the <Edit Contents> menu option (above) to complete all form sections and always remember to <Save> your page (see the button at the bottom right) (Note: We recommend that you NOT click the <Save Draft> button because its operation is not intuitive, you may lose your work). If you are unable to complete the entire form in one session, you may return multiple times to complete it using <Edit Contents> and <Save> when finished.
To indicate to the Program Admin Staff that you are finished working with the EoI Form, please complete the "Consent and Authorization" area at the bottom and click <Save>. As soon as realistically possible, Program Admin Staff will validate your final submission for completeness and subsequently restrict it from further editing
The right column contains data fields which are either free-form text, drop-down selection menus, or numeric. For certain text fields, clicking your mouse in the cell will bring up an Editor offering an extensive menu at the top containing formatting options including: headings, fonts, bullets, paragraph indentation, links, tables, and an insert menu offering even more capabilities (e.g., images, attachments).
As a precautionary measure, there are very few embedded links in this EoI Form to prevent being transported out and potentially losing your work. External materials that can be referenced are marked in orange bold text. If you need to consult any of these documents, be sure to <Save> your active page (see the button at the bottom right of this Form) and return to it when convenient. If you are comfortable working in multiple tabs/windows and want to visit any external source while working in this document, be sure to <Right-Click> the link using your mouse (or pointing device) to open it in another tab/window. For your convenience, all documents and materials referenced in this year's application process are contained on these pages:
- At-Large Board Member Candidate Requirements - 2017: https://community.icann.org/x/HAu4Aw
- At-Large Board Member Candidate Reference Links & Resources - 2017: https://community.icann.org/x/Jgu4Aw
If you have any questions about this process, please send an email to the Program Admin Staff.
- DO NOT change the Page Title (top left) under any circumstances.
- This EoI Form must be completed in English. Please set your browser in the English language setting in order to avoid auto-translation of the EoI Form by your browser to other languages.
- All EoI forms will be closed to further editing effective 23:59 UTC on Friday, 18 November 2016
- Please use the <Edit Contents> menu option (above) to complete all form sections and always remember to <Save> your page. You may resume your progress and return multiple times to complete the EoI Form using <Edit Contents> and <Save> when finished.
- When you have finished entering ALL of the applicable information for this EoI Form and are prepared to release it to the BCEC, please complete the Consent & Authorization immediately below Section D.
Section A: Identification, Contact Information, Resume, and Professional References
In order to provide Candidates with as many options to promote their qualifications as are feasible, the BCEC is inviting each Candidate to submit a photograph in the form of an uploaded picture/image.
IMPORTANT: If you choose not to take advantage of this option, there will be no detrimental effect upon your candidacy.
To provide a picture, please read the instructions below.
Click in the field to the right to open up the text input window. Then click the <"+" Insert more content> menu button, select <Image>, then choose (or browse) to locate an image file (e.g., JPG, PNG, BMP) from your local computer to upload. After insertion, please click on the picture and adjust the size to no larger than 200 pixels.
|3) Email Addresses:|
4) Telephone/Contact Numbers:
Please include all international, country, and city/area codes, e.g., +64 1111 2222. Use the "+ Add Row" to add additional rows to the table; the "x" can be used to delete rows added by mistake.
|5) Country of Citizenship:|
If you have multiple citizenships, please list them comma-separated.
Domicile means the country that you treat as your permanent home, or live in and have a substantial connection with. If you reside in more than one country, please state the percent of time you reside in each country as a whole digit number without the '%' sign. Use the "+ Add Row" to add additional rows to the table; the "x" can be used to delete rows added by mistake.
7) If you have a personal Web page, Blog, Facebook, Twitter or YouTube Channel, you may provide links here.
Click inside the text box to open the input window. Highlight one of the bullets; then, from the top menu, select Link, choose Web Link, then enter the information. You may alter the appearance in the "Link Text" field or accept the default. Click Done and the information will be inserted as automatically linkable.
If you have a resume or curriculum vitae (C.V.), the Committee would appreciate having it uploaded it to this page (PDF preferred) and then linked within this question. Your uploaded resume should not exceed the equivalent of five (5) single-spaced typewritten pages.
Click inside the text box (right column) to open the input window. On the top menu, click the <"+" Insert more content> menu button; select Attachment; then use the Choose File (or Browse) option to locate the document on your computer. You may alter the link's appearance by adding a description in the "Link Text" box at the bottom of the window.
|9) Professional References:|
Please provide the names of no less than three (3) and no more than four (4) people who know you in a professional capacity and are willing to provide you a written Reference for your candidacy at short notice.
As soon as possible after the deadline for submission of EoI Forms at 23:59 UTC on Friday, 18 November 2016, the BCEC and its Program Admin Staff will contact each of the people you name as a Referee directly to request their written References to be submitted by 23:59 UTC on Friday, 2 December 2016. Referees may subsequently be approached to answer questions or provide clarification.
The BCEC may send a copy of your EoI Form to each of the people you name as a Referee.
Before submitting your Referees' names and contact information via this EoI Form, Candidates must explain to their Referees the purpose of the At-Large Board Member Selection process and obtain their Referees’ consent that they are willing to be contacted to send written References and answer questions or provide clarifications at short notice.
The BCEC recommends that Candidates choose their Referees carefully so the BCEC has a broad view of a Candidate’s experiences and abilities. Individuals from the following groups may not be submitted as Referees:
The BCEC will not consult as a Referee anyone who is also a Candidate under consideration for the At-Large Board Member. The BCEC encourages Candidates to identify this issue with any prospective sources to avoid an unusable Reference. Because of our confidentiality commitment, the BCEC will be unable to advise Candidates about another person's presence in the Candidate pool. This will become evident when the list of all Candidates names is made publicly available; however at that stage it will be too late to submit a substitute Reference.
In the column to the right, please provide your Referee's name, e-mail address, telephone number, professional position, and a brief description of your relationship with them.
Use the "Add Row" to add additional rows to the table; the "x" can be used to delete rows added by mistake.
Section B: Qualifications & Professional Background
Purpose of This Section
The purpose of Section B is to help the Committee understand the skills and experience you would bring to ICANN, how you would help ICANN achieve its mission, and how you meet the criteria for the leadership position the BCEC will fill. Please refer to the At-Large Board Member Candidate Requirements - 2017 page for a description of the criteria. The BCEC needs to understand why you are the right person for the position to which you are applying. Please be bold in telling the Committee about yourself and your ideas.
|1) Please describe any current and past volunteer positions, roles, and accomplishments. The Committee is particularly interested in Board or similar directorship experience. Please include the name and web page of such organizations, if applicable.|
|2a) Have you held or do you currently hold a Board or executive management position in any organization?|
|2b) If "Yes," please state the nature and size of the organization(s) in which you currently hold or have held a Board or executive management position.|
|3a) Do you have experience working with non-profit organizations?|
|3b) If "Yes," please state the nature and size of any non-profit organization(s) including any Board positions or executive committees upon which you currently serve or have served.|
|4) Briefly describe any experience you have had working with groups in various locations and time zones around the globe.|
|5) Being able to read and to express yourself publicly in English is mandatory for leadership positions at ICANN. Do you meet this criterion?|
6) Which other languages do you speak and at what level of fluency?
Use the "+ Add Row" to add additional rows to the table; the "x" can be used to delete rows added by mistake.
Section C: Internet & ICANN Involvement
1) Describe your current and past involvement in, contributions to, and leadership roles in activities and organizations involved in the development and operation of the Internet, its naming and addressing infrastructure, and/or its security and stability.
Please describe any involvement with the operation of ccTLD, gTLD registries or registrars, IP address registries, or relevant DNS technical or policy development process, including Internet technical protocols and standards. Your answer should include details of any involvement with ICANN's policy development processes, including its creation and evolution; Supporting Organizations; Councils; and/or Advisory Committees.
2) Conflicts of Interest
Please indicate clearly if you have any areas of actual or potential conflicts with ICANN. Please refer to the ICANN Conflicts of Interest Policy which specifically addresses conflicts for ICANN Directors, Officers and key employees. If you have had any relationship with an ICANN accredited registry or registrar (other than registering a domain name) or any organization that has been in dispute with ICANN, please describe that relationship here. Conflicts of interest are not necessarily disqualifying, since we anticipate that many experienced people may have such relationships. The At-Large Community selected Board Member should be independent from ICANN Stakeholders whose financial situation is significantly affected by ICANN decisions.
|3) Please explain any positions you hold as Director, major shareholder, or employee of a Generic Top Level Domain (gTLD) Registrar or Registry, Country Code Top Level Domain (ccTLD) Registry or a Regional Internet Registry (RIR).|
Section D: Application for At-Large Board Member Position
|1) Please state your opinion about what would be your unique expertise or perspective and what added value you might contribute to the ICANN Board:|
2) Please describe how and why you meet the criteria for this position:
See At-Large Board Member Candidate Requirements - 2017 document for eligibility criteria and other selection factors. Describe how your work and other experience helps you meet the criteria for the position you are applying for. You may wish to describe how your previous experience is relevant to your candidacy.
|3) Please state what you would contribute in the At-Large selected ICANN Board Member Position to the At-Large Community|
|4) Please describe specifically how and why you will be able to advance, at the ICANN Board, the interests of the At-Large Community and the broader global community of Internet end-users.|
5) Time Commitment:
The basic responsibilities of an ICANN Director require a minimum commitment of time which when averaged out over the year is roughly equivalent to 20-24 hours each week. This includes participation in three ICANN meetings/year, two Board retreats/year and work on Board Committees. The time spent in these basic responsibilities is typically clustered around Board meetings and monthly teleconferences, but there is a constant flow of information requiring attention on a near daily basis.
Directors are expected to attend three ICANN meetings per year and depending on the location and including travel time and preparation this could be a commitment of about ten (10) days per meeting. In addition the board occasionally holds shorter face-to-face meetings such as retreats.
Directors spend additional time in connection with their work on Board Committees, a commitment that varies in relation to the number of Committees on which they serve, the scope of the Committee's responsibilities, and their role as Chair or Member of the Committee.
Are you able to commit this amount of time for this position?
|6) Please describe your understanding of changes to ICANN's Bylaws, organizational structure, and accountability mechanisms that have been put in place as part of the transition of the stewardship of IANA functions. Please also describe any personal involvement you have had in these changes.|
Consent and Authorization:
Please click here to complete the Consent and Authorization section of this EoI Form
At-Large Board Candidate Application Template v1 (Oct 2016)