At-Large Statement of Interest (SOI) Form
1) Please enter your Name:
3) Are you participating in the At-Large advisory process (including email and real-time discussions) as a representative of:
a) ALAC (if so, detail the region and term):
EURALO, February 2017 - 2018 AGM
b) A Regional At-Large Organization (RALO) (if so, please detail the region, position and term):
c) An ICANN-accredited At-Large Structure (if so, which one):
Internet Society Netherlands chapter
d) Any ICANN Committee, Constituency or Stakeholder Group (if so, which one(s))?
e) Any other company or organization, whether commercial or nonprofit (if so, please detail the organization and your position):
• Board member ISOC NL chapter (isoc.nl) • Team member industry body Digital Infrastructure Netherlands foundation (dinl.nl) • Chair regulatory affairs working group Euro-IX (euro-ix.net) • Board member Brasil Art Factory (organizer of Brazilian film festivals and currently making a documentary)
4) Please identify your current employer(s):
AMS-IX B.V. (ams-ix.net)
5) Please identify your current position(s):
6) Please identify the type(s) of work performed:
Policy drafting, acting as regulatory- and public affairs spokesperson, build up expertise and reflect/provide input on Internet Governance discussions and (drafting of) Telecommunications’ legislation, service- and SLA-management, project management, network engineering/UNIX sysadmin, advisory and consultancy work, financial accounting, writing articles, speaking at (international) industry events and participating in panels/workshops/roundtables
7) Please identify your declared country of primary residence:
8) Please list any financial relationship beyond de minimus stock ownership you may have with any company that to your knowledge has a financial relationship or contract with ICANN:
9) Please identify any other relevant arrangements, interests, or benefits as requested in the following two questions:
a) Do you, your employer, and/or sponsor have any type of material or financial interest in the At-Large advisory process and its outcomes?
If the answer is “Yes,” please describe the interest:
b) Are there any arrangements/agreements between you and any other group, constituency or person(s) regarding your participation as a work team member?
If the answer is “Yes,” please describe the arrangements/agreements and the name of the group, constituency, or person(s):
10) Please identify any Working Groups or other chartered teams in which you are participating (include acronyms, if applicable):
At-Large Public Interest, Registration Issues and ICANN Evolution Working Groups, At-Large Review Working Party, EURALO ALS Engagement Task Force, and CCWG WS2 Human Rights subgroup participant. Furthermore DINL is in the process of becoming a member of the ISPCP, and once that is the case I will be their liaison towards the ISPCP.
11) Additional information (optional):
12) Page last revised:
At-Large SOI Template v3 (Feb 2014)