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At-Large Statement of Interest (SOI) Form

1) Please enter your Name:


Fotjon Kosta

2) Picture/Image:
(Instructions: Click in the field to the right to open up the text input window. Then click the <Insert> 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) 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):


Member of EURALO Association

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):


European Individual Users' Association

European Individual Users' Association 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):


- Coordinator and Member of Albania IGF Contributor to internet governance as IGF, EURODIG, SEEDIG

4) Please identify your current employer(s):


Ministry of Infrastructure and Energy, Government of Albania

5) Please identify your current position(s):


ICT\cybersecurity expert

6) Please identify the type(s) of work performed:


Albania IGF (volunteer)

7) Please identify your declared country of primary residence:


&nbsp;Albania, Europe

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:


none

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):

11) Additional information (optional):


12) Page last revised:


20-Sep-2017

 

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At-Large SOI Template v3 (Feb 2014)

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