At-Large Statement of Interest (SOI) Form
1) Please enter your Name: | <p> NATALIA ENCISO BENITEZ<br/></p> |
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2) Picture/Image: | |
3) Are you participating in the At-Large advisory process (including email and real-time discussions) as a representative of: |
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a) ALAC (if so, detail the region and term): | <p> Alac member 2012/2013<br/></p> |
b) A Regional At-Large Organization (RALO) (if so, please detail the region, position and term): | <p> LACRALO<br/></p> |
c) An ICANN-accredited At-Large Structure (if so, which one): | <p> APADIT<br/></p> |
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): | <p> Independent Professional<br/></p> |
5) Please identify your current position(s): | <p> Latin Notary Public<br/></p> |
6) Please identify the type(s) of work performed: | <p> Legal affairs, IT Law counsel<br/></p> |
7) Please identify your declared country of primary residence: | <p> Paraguay<br/></p> |
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: | <p> N/A<br/></p> |
9) Please identify any other relevant arrangements, interests, or benefits as requested in the following two questions: |
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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? | No |
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? | No |
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 Whois, ROPs, Icann Academy, Capacity Building, Governance (LACRALO) |
11) Additional information (optional): | |
12) Page last revised: | 11-Dec-2012 |
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At-Large SOI Template v3 (Feb 2014)