At-Large Statement of Interest (SOI) Form
1) Please enter your Name:
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):
b) A Regional At-Large Organization (RALO) (if so, please detail the region, position and term):
European Regional At-Large Organisation (EURALO), Secretary (since June2011 until June 2013)
c) An ICANN-accredited At-Large Structure (if so, which one):
iNGO European Media Platform (certified in spring 2010)
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):
ISOC Ukraine Chapter in Formation Initiative Group IGF-UA co-organizer At-Large Council at National Council on Broadcasting At-Large Council at National Commission for the State Regulation of Communications and Informatization
4) Please identify your current employer(s):
iNGO European MediaPlatform
5) Please identify your current position(s):
Director of iNGO European Media Platform
6) Please identify the type(s) of work performed:
I worked as foreign press observer in Ukrainian newspaper Zerkalo Nedeli, initiated the creation of iNGO European Media Platform. Organizer of the series of the round tables in Ukrainian Parliament, IGF-UA I, II, and III, Forum "Media for information society."
7) Please identify your declared country of primary residence:
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:
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):
I am a member of the ALAC WG on the ICANN Academy, IDN Variant WG
11) Additional information (optional):
12) Page last revised:
At-Large SOI Template v3 (Feb 2014)