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):
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):
ViceChair of the San Francisco Bay ISOC (SFBayISOC) chapter. -- SFBayISOC is a member of NARALO. -- I am the Primary contact for the SFBayISOC At-Large Structure
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):
4) Please identify your current employer(s):
Not working for an employer currently. Currently doing research related to the Digital Divide Technology Solutions proposal to the ICANN NARALO and Internet Society (ISOC) North America groups.
5) Please identify your current position(s):
6) Please identify the type(s) of work performed:
Currently doing Research on topics related to digital divide technology solutions.
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):
-- ATLAS II. Newsletter subgroup. -- If the Digital Divide Technology Solutions proposed workgroup is established, will lead that group. -- Also looking to engage with ICANN groups engaged with the Internet Governance Forum.
-- ATLAS II. Newsletter subgroup.
-- If the Digital Divide Technology Solutions proposed workgroup is established, will lead that group.
-- Also looking to engage with ICANN groups engaged with the Internet Governance Forum.
11) Additional information (optional):
Have proposed to the NARALO group the creation of the Digital Divide Technology Solutions Workgroup. Status is in exploratory phase at this time.
12) Page last revised:
At-Large SOI Template v3 (Feb 2014)