Statement of Interest ICANN Nominating Committee 2006 Introduction Any individual who wishes to be considered for selection by the Nominating Committee (NomCom) will need to complete an ICANN Nominating Committee Statement of Interest (see below), in full, and return it to the NomCom. Due to technical considerations, NomCom can only consider electronic submissions via e-mail. To be considered by the NomCom, the Statement of Interest must be received by the NomCom no later than 1 August 2006 (23:59 GMT). Send your completed Statement of Interest, in plain text, to nomcom.submissions@icann.org. It is in your best interest to submit your Statement of Interest as soon as possible so that NomCom can follow up with your references or with you if it has any questions. The NomCom's procedures call for confidential treatment of the identities of Candidates and the NomCom's discussions about the Candidates. In performing its function, however, the NomCom will consult Candidates' references and may conduct third-party reference checks on a confidential basis. In addition, due diligence of Selected Nominees will be undertaken by a professional company experienced in such work. Once selections are made, the NomCom will make only the identities of the Selected Nominees public. Although NomCom has adopted a strong technical and security policy to deal with information concerning the Candidates (see NomCom Procedures), and will take reasonable steps to ensure that its confidentiality procedures are followed, confidentiality cannot be fully assured and Candidates and Selected Nominees shall have no claims against ICANN, the NomCom, or affiliated persons in the event information is disclosed despite these procedures. The Statement of Interest will ask you for various authorisations and consent. The NomCom relies heavily on the information you provide in this statement of interest, and the information given by the people you ask to be your references. We are unlikely to contact you again for more information, although in some cases we may ask for clarification. While some members of the NomCom may know you, the primary sources of information about you and your qualifications for appointment are your statement and the references you provide. Be thoughtful in the information you provide to help the NomCom learn as much about you as possible. Choose your references carefully so they provide a broad view of your experiences and abilities. Be sure to ask the people you select as references before submitting their names to the NomCom; they should know they have been asked to provide a reference and its purpose and you should be confident they will do so. Please read the "Leadership Positions", "ICANN Conflicts of Interest Policy" and "Nominating Committee Procedures" documents carefully before completing this Statement of Interest. These can all be found linked from the committee's webpage . To help you answer the questions we have provided a Notes sheet at the end of this document. Please refer to the Notes whenever the form tells you to. Timeline The nominating committee will begin accepting statements of interest on 18 April, 2006. All statements of interest should be returned by 1 August 2006 (23:59 GMT). Selected nominees will be announced before one month before the annual general meeting to be held in Sao Paolo, Brazil. Candidates who are not appointed will also be advised of the decision in approximately this same time frame. The time between 1 August 2006 (23:59 GMT) and the announcement of Selected Nominees will be used to collect references, to evaluate these, and conduct any due diligence (see question D.1 below.) If your circumstances change during this period please write to the nominating committee at the following email address explaining these changes . Terms for all positions begin at the end of the 2006 ICANN annual general meeting to be held in Sao Paolo, 2-8 December 2006. Selected nominees will be invited to attend this meeting. For full consideration of your statement of interest please : - complete in full the statement of interest below, answering all questions (question D.3. is optional) using English, and without the use of additional attachments; - provide your responses to the statement of interest categories in order, immediately following the heading for that category; - make your response sufficient to stand alone without reliance on linked resources; - provide the meaning of any acronyms used to reference an organization or activity, and state the purpose of the organization or activity; - limit your responses to less than 3,500 words (in total) and focus your responses carefully in terms of the nature of the position(s) for which you wish to be considered to give the NomCom a clear picture of your candidacy; - understand that the NomCom does not commit to review material that you reference by URL links in your response: your SOI should be self-contained. To receive full consideration statements should be received before 1 August 2006 (23:59 GMT). The selection of selected nominees will be announced before 31 October 2006. You must answer all questions below, except question D.3 which is optional. Statement of Interest Form, 2006 Please complete in plain text, do not use formatted text (no bold, underline, italic, colour, etc. URLs may be helpful, but understand that for reasons beyond nominating committee's control we may not be able to view linked material.) Send the completed form by email to nomcom.submissions@icann.org. SECTION A. Identifying and Contact Information. Please refer to Note 1. (A.1) Your name: first name, FAMILY NAME (in capital letters) (A.2) Male/Female? (A.3) Your e-mail address (A.4) Your telephone number(s) (please include country and city/area codes and indicate your preferred contact number.) (A.5) Your country of citizenship (If multiple citizenships please state all.) (A.6) Your country of residence (A.7) Provide details of your current job, title, employer or affiliation Please refer to Note 2. (A.8) Describe your educational background and past professional positions Please refer to Note 3 SECTION B. Background and Interests. Please refer to Note 4. This section asks questions we hope will tell us about your candidacy, how your experience makes you suitable for the position(s) you would like to be considered for, the qualities you will bring to ICANN and how you will help ICANN over the coming years. (B.1) Position(s) for which you would like to be considered. If you would like to be considered for more than one position, please state so, categorizing each position with numbers, in your order of priority (i.e., 1 is your highest priority) ICANN Board ___ GNSO Council ___ ccNSO Council ___ Interim ALAC ___ Please refer to Note 5. (B.2) Describe how you meet the criteria for each of the positions you are applying for. Please refer to Note 6. (B.3) Describe any current and past involvement in, contributions to, and leadership roles in activities and organizations involved in the development and operation of the Internet's naming and addressing infrastructure. Please refer to Note 7. (B.4) Describe any current and past volunteer positions, roles and accomplishments. (B.5) Provide a statement about what you would contribute to ICANN and its mission. Please refer to Note 8. SECTION C. References and Related Information. This section asks for additional information about your candidacy, the names of people you would like to provide references, and information indicating you agree to due diligence and other checks ICANN may carry out. (C.1) Conflicts of interest with ICANN. Please indicate clearly if you have any areas of potential conflicts with ICANN. Actual and potential conflicts of interest will not be disqualifying. Please refer to Note 9. (C.2) All positions are voluntary and require a significant commitment of time and energy. Is your schedule of activities compatible with a significant allocation of time to contribute to the positions that you are looking for? Board / GNSO / ccNSO / ALAC Please refer to the description of the commitment required in the "Leadership Positions" document. Please indicate Yes or No: [ ] Y [ ] N (C.3) Please provide the names of no less than 3 and no more than 4 people who can provide a reference for your candidacy. Please provide the person's name, e-mail address, telephone number, professional position, and a brief description of your relationship with them. Please refer to Note 10. Reference 1: Reference 2: Reference 3: Reference 4: NomCom will send a copy of your SOI to each of the people you name as a reference. SECTION D. Consent and Authorisation. (D.1) Under the nominating committee's procedures, your candidacy will be treated as confidential unless you give the nominating committee your permission to disclose it or unless the nominating committee is consulting your references and conducting third-party reference checks from selected sources on a confidential basis. These third party checks are required as part of a due diligence process necessary before we can accept candidates for leadership positions in ICANN. Due diligence will be conducted by professional companies experienced in such work (i.e. executive recruitment and other human resources organizations.) Once selections are made, the nominating committee will make the identities of only the Selected Nominees public. Although the nominating committee will take reasonable steps to ensure that its confidentiality procedures are followed, Candidates and Selected Nominees shall have no claims against ICANN, the nominating committee, or affiliated persons in the event information is disclosed despite these procedures. You also authorize the nominating committee to consult with your references and conduct third-party reference checks. You will not be entitled to review or access any of the information received, generated, or considered by the nominating committee regarding any Candidate or Selected Nominee, or any of the nominating committee's discussions or deliberations regarding any Candidate or Selected Nominees. Candidates and Selected Nominees have no right to challenge or seek review of the nominating committee's selections. Please indicate that you understand this statement and agree to it. Indicate Yes or No: [ ] YES [ ] NO (D.2) From time to time, due to a change in employment or other circumstances, a mid-term vacancy may occur in previously NomCom appointed leadership positions. If a vacancy is for more than three months in length, the Chair of the next NomCom may be asked to fill the vacancy. If you are NOT selected for any of the preferences indicated in (B.1.) above this year, would you permit the Chair of this year's NomCom to retain your name (based on the same preferences) and transfer your statement of interest to the Chair of the 2007 NomCom for possible consideration in the event that a mid-year vacancy occurs in 2007? This is only in the event that a mid-term vacancy occurs and does not mean you will be included in the pool of candidates for regular term positions next year Žâ€“ you would need to apply again. Please indicate Yes or No: [ ] YES [ ] NO If your Answer to the above is YES, please indicate whether the same preferences indicated by you in (B.1) above would be applicable or whether you would have any ONE specific interests? Please state clearly your specific interest. Please confirm your understanding of and agreement with the above conditions by marking the box below: _____Yes, I agree to be a Candidate under these confidentiality arrangements and other terms outlined herein, listed in full in the Formal Call for Statements of Interest and Suggestions for Candidates at http://icann.org/committees/nom-comm/. (D.3) Is there any additional information you would like to submit that would be helpful to nominating committee in making its decision? If so, please summarize it here: If you have a personal web page, you may wish to provide a link to it here: The nominating committee values your interest in being a candidate for the positions it is charged to fill. We expect and rely on your integrity in presenting your qualifications and experience. We appreciate your effort in completing this Statement of Interest. NOTE Form: Statement of Interest ICANN Nominating Committee 2006 Please use these Notes to help you answer the questions in the statement of Interest. You should read these notes carefully before answering. NOTE 1. Section A. Identifying Information. Section A asks for information about your personal background, the type of information typically provided in a CV or resume, however, please do not attach your CV to this statement. NOTE 2. Information about employment. Please provide your current job title and name of your employer. If self-employed mention your area of work. Briefly, in not more than 75 words, describe your current job and your duties. NOTE 3. Education and professional background. The nominating committee does not need to see an exhaustive list of education and work experience. Summarize your educational background, such as degrees achieved and the university(s) where you studied, and three most recent places of employment and positions held. NOTE 4. Section B. Background and Interests. The purpose of the questions in Section B is to help us understand the skills and experience you would bring to ICANN, and how you meet the criteria for the leadership positions the nominating committee will fill. Please refer to the "About Positions" document for details of these criteria. The nominating committee needs to understand why you are the right person for the position(s) you wish to apply for. Please be bold in telling the committee about yourself and your ideas. If you are a citizen of, or resident in, multiple countries please provide us with additional details and where relevant refer to this aspect in your answers to Section B, Background and Interests. Note 5. Interim ALAC vacancies Interim ALAC vacancies in 2006 are only for citizens of countries from European and North American regions, see for a description of ICANN's geographic regions. If you are not from one of these regions, please do not apply for an ALAC position this year, but do check for vacancies next year. NOTE 6. Satisfying eligibility and other selection criteria. See "Leadership Positions" document for eligibility criteria and other selection factors. Describe how your work and other experience helps you meet the criteria for the position(s) you are applying for. You may wish to describe how your work experience is relevant to your candidacy. NOTE 7. Familiarity with the Internet's naming and addressing infrastructure and other Internet technical functions coordinated by ICANN. The nominating committee would like to know about your familiarity with the Internet's naming and addressing infrastructure, then domain name system and other Internet technical functions coordinated by ICANN, both in technical and policy matters. Please describe any involvement with the operation of ccTLD, gTLD registries or registrars, IP address registries, or relevant DNS technical or policy development process, including Internet technical protocols and standards. Your answer should include details of any involvement with ICANN, its policy development processes including its creation and evolution, supporting organizations and councils. Your answer may overlap with your response to question B.2. NOTE 8. Contribution to ICANN and its mission. Please state clearly how you see yourself contributing to ICANN and its mission. Please highlight your personal skills and experience that would be beneficial to the organization. You should mention specific past or current contributions in fields such as international relations, technical leadership, managerial skills, languages, etc., as well as goals for your contribution in the desired position. NOTE 9. Conflicts of Interest. Please refer to the ICANN Conflicts of Interest policy . This document is aimed at conflicts for ICANN Directors and Officers, but should provide guidance for all ICANN leadership positions. If you have had any relationship with an ICANN accredited registry or registrar (other than registering a domain name) or any organization that has been in dispute with ICANN, please describe that relationship here. Conflicts of interest will not be disqualifying, we anticipate many experienced people may have such relationships. NOTE 10. Selecting references. You must ask the people you select as references for their agreement to do so before submitting their names to the nominating committee. They should know they will be asked by the NomCom to provide a reference and understand its purpose. Provide them with your statement of interest (this completed form) so that they can respond knowledgeably to our request for information. We recommend that you choose your references carefully so the NomCom has a broad view of your experiences and abilities. - Current nominating committee members must not be included as references. - Current ICANN staff must not be included as references. The nominating committee will not consult as a reference anyone who is also a candidate under consideration, but because of our confidentiality commitment, nominating committee will be unable to advise candidates about another person's presence in the candidate pool. We will ensure that your candidacy is not harmed should this occur.