1) Your Name:
|2) Stakeholder Group:||Non-Commercial|
|Non-Commercial Users (NCUC)|
4) ICANN Affiliation (if not covered by item 2 or 3):
NCSG representative on the GNSO Council
5) Please identify your current employer(s):
Fundação Getulio Vargas - Center for Technology and Society of Rio de Janeiro Law School
6) Please identify your current position(s):
Researcher and coordinator
7) Please identify the type(s) of work performed:
Research activities on Internet Governance and Human Rights. Management of CTS/FGV
8) Please identify your declared country of primary residence (e.g., country to which you pay taxes):
9) 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:
10) Do you believe you are participating in the GNSO policy process as a representative of any individual or entity, whether paid or unpaid?
|If the answer is “Yes,” please provide the name of the represented individual or entity. (If professional ethical obligations prevent you from disclosing this information, please enter "Private"):|
When stated explicitly, I may represent a viewpoint of NCSG.
|11) Please identify any other relevant arrangements, interests, or benefits as requested in the following two questions:|
a) Do you have any type of material interest in ICANN GNSO policy development processes and outcomes?
If the answer is “yes,” please describe the material interest in ICANN GNSO policy development processes and outcomes:
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):
I represent NCSG interests in the GNSO Council
12) Please identify any Working Groups or other chartered teams in which you are participating (include acronyms, if applicable):
Non-commercial Stakeholder Group Policy Committee (NCSG-PC)
Cross-Community Working Group on Internet Governance (CCWG IG)
13) Additional Information (optional):
14) Page last revised:
SOI Template v5 (6 Feb 2014)