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NAME:

COUNTRY OF RESIDENCE:

OCCUPATION:

EMAIL ADDRESS:

OTHER CONTACT DETAILS:   (OPTIONAL)

I confirm that:

1. I am not a member of a any certified At-Large Structure (ALS)
2. I am subscribed to the APRALO emailing list
3. I am a permanent resident of a country within the APRALO Asia-Australasia-Pacific Region
4. If I hold a leadership position in another Supporting Organization (SO) or Advisory Committee (AC), I am aware that I am not eligible for a leadership position in APRALO
5. I am aware that I do not automatically qualify for any funding for travel or other expenses from ICANN or APRALO
6. I am aware that upon ceasing to meet any of the above criteria, my unaffiliated membership will be automatically terminated
7. I do not have any conflicts of interest as defined by APRALO Rules of Procedure Section 27.5.2.7 (see below).

YES

STATEMENT OF INTEREST:

Current or prior experience in representing the interests of Internet consumers or end-users:

Potential interest areas within APRALO, AT-LARGE or ICANN (Please select from the list below):1)

1. Accessibility

1. Accountability

1. ccTLD Policy

1. Community Networks

1. Consumer Protection

1. Contract Party Agreements

1. Data Protection

1. Development

1. DNS

1. E-commerce, E payments

1. Education

1. Engagement

1. Freedom of Expression

1. Free Use of Encryption

1. Human rights

1. IANA

1. ICANN Board/Bylaws/structures

18) IDN

1. Internationalized Domain Names and Universal Acceptance
2. Intellectual Property

1. Internet Governance

1. Internet Infrastructure

1. Internet Protocols

1. Legal/Regulatory

24) NewTLDs

1. New TLDs
2. New/Social Media

1. Net Neutrality

1. Open data/access

1. Policy Progress

1. Privacy

1. Public Interest

1. Reviews/Improvement

1. Security/Stability

1. WHOIS

1. Any other

  other