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Name: 
Email: 
Organization:

Please select one from the drop-down list:

    • Registry Stakeholder Group
    • Registrar Statkeholder Group
    • Business Constituency
    • Intellectual Property Constituency
    • Internet Services Provider Constituency
    • Non-Commercial Users Constituency
    • Not-for-Profit Operational Concerns Constituency
    • At-Large/ALAC
    • Other ICANN SO/AC
    • Representing Self
    • Other (please describe): _____________________
Working Group Role:

Please select one the most descriptive role that you fulfilled on the WG from the drop-down list:

    • Leader (Chair, Co-Chair, Vice-Chair, Other Officer)
    • Contributing Member
    • Background Contributor
    • Liaison
    • Observer
    • Advisor/Consultant
    • Support (e.g., secretary, technical, administrative)
    • Other (please describe): _____________________

...

Assessment CategoryRating

The Charter/Mission of the WG where:
1-Highly Ineffective means confusing, vague, ill-structured, unbounded, unrealistic (e.g., time, constraints), unachievable; and
7-Highly Effective means understandable, clear, well-structured, bounded, realistic (e.g., time, constraints), achievable

1234567SKIP

The Expertise of WG members where:
1-Highly Ineffective means novice, elementary, inapplicable, unusable; and
7-Highly Effective means knowledgeable, advanced, applicable, usable

1234567SKIP

The Representativeness of WG members where:
1-Highly Ineffective means narrow, skewed, selective, unbalanced; and
7-Highly Effective means broad, diverse, balanced

1234567SKIP

The external Human Resources (e.g., briefings, experts, consultants, liaisons) provided to the WG where:
1-Highly Ineffective means inappropriate, inadequate, untimely, not helpful/useful; and
7-Highly Effective means appropriate, adequate, timely, helpful/useful 

1234567SKIP

The Technical Resources (e.g., systems, tools, platforms, templates) provided to and utilized by the WG where:
1-Highly Ineffective means difficult, challenging, clumsy, awkward, tedious, slow, not helpful/useful; and
7-Highly Effective means easy, straightforward, clear, efficient, fast, helpful/useful 

1234567SKIP

The Administrative Resources (e.g., support, guidelines, documentation) provided to and utilized by the WG where:
1-Highly Ineffective means inappropriate, inadequate, untimely, not helpful/useful; and
7-Highly Effective means appropriate, adequate, timely, helpful/useful 

1234567SKIP
Comments about the WG's Inputs: (Free-form Text Box)
III. Processes ...includes norms, operations, logistics, and decision-making.
Thinking about the overall EFFECTIVENESS of the Working Group's Processes, how would you rate each of the following elements on a scale where 1=Highly Ineffective and 7=Highly Effective:
Assessment CategoryRating

The Participation climate within the WG where:
1-Highly Ineffective means inhospitable, unilateral, frustrating, unproductive; and
7-Highly Effective means inviting, democraticinclusive, accepting, respectful, productive

1234567SKIP
The Behavior of WG members where:
1-Highly Ineffective means disruptive, argumentative, disrespectful, hostile, domineering; and
7-Highly Effective means accommodating, respectful, collaborative, consensus-building
1234567SKIP

The Decision-Making Methodology (consensus)where:
1-Highly Ineffective means broken, ignored, not observed, disrespected; and
7-Highly Effective means honored, followed, observed, respected

1234567SKIP

The Session/Meeting Planning (Agenda) where:
1-Highly Ineffective means disorganized, haphazard, unstructured, untimely notice; and
7-Highly Effective means organized, disciplined, structured, timely notice

1234567SKIP
Comments about the WG's Processes:(Free-form Text Box)
IV. Products and Outputs

...

Assessment CategoryRating

The Working Group's primary Mission where:
1-Highly Ineffective means not achieved and/or accomplished per the Charter; and
7-Highly Effective means completely achieved and/or accomplished as directed

1234567SKIP
The Quality of the WG's outputs (a.k.a. deliverables) where:
1-Highly Ineffective means incomplete, inadequate, materially deficient/flawed, unsupported; and
7-Highly Effective means complete, thorough, exhaustive, reasoned, supported
1234567SKIP
Comments about the WG's Products and Outputs:(Free-form Text Box)
V. Personal Fulfillment and Demographics
Your Chartering Organization is interested to learn about your own Participation and personal Fulfillment as a result of having invested time and effort volunteering on a Working Group. In addition, we have included a few Demographic questions that will assist in understanding and interpreting your feedback. 
Assessment CategoryRating

My personal Participation in helping the WG achieve its mission where:
1-Highly Ineffective means immaterial, negligible, insignificant, unimportant
7-Highly Effective means material, substantial, significant, important

1234567SKIP

My personal Fulfillment considering the time, energy, and work efforts I contributed to this WG:
1-Highly Unrewarding; and
7-Highly Rewarding

1234567SKIP
How did you learn about the WG?

 

Please select one from the drop-down list:

  • I was informed or invited by my SG/C or ICANN-affiliated organization
  • I was contacted by an ICANN Staff member
  • I was contacted by an individual seeking to recruit volunteers for the WG (e.g., GNSO Councilor, interim Chair)
  • I learned about the WG through one of ICANN's websites (or Wikis)
  • I learned about the WG from another organization not directly associated with ICANN
  • A professional colleague or associate informed me about the WG
  • Other (please describe): _________________________________
Approximately how long have you been involved with ICANN:

Please select one from the drop-down list:

    • Less than 1 year
    • 1 - 2 years
    • 2 - 4 years
    • 4 - 6 years
    • 6 - 8 years
    • More than 8 years
Considering the most recent twelve months, on average, approximately how many hours per week do you spend on ICANN-related activities:

Please select one from the drop-down list:

    • Less than 10 hours
    • 10 - 20 hours
    • 20 - 40 hours
    • 40 - 60 hours
    • 60 - 80 hours
    • More than 80 hours
Comments about Personal Fulfillment and Demographics:  (Free-form Text Box)
Additional Comments:
(Please feel free to provide any additional comments feedback about your Working Group experience,
this Self-Assessment, or any other matter not covered elsewhere in this questionnaire:)		(Free-form Text Box)

THANK YOU FOR YOUR FEEDBACK! 

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