GNR Stakeholder Group Application

GNR Stakeholder Group Application
Name*

PrefixFirst NameLast Name
CV*

Cancelof
Current job title: fill in the blank*
Affiliation: fill in the blank*
Since year: fill in the blank*
Email*
example@example.com
Phone Number

Country CodeArea CodePhone Number
Address for correspondence

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Gender*
Date of birth

MonthDayYear
Date
Nationality*
Mother tongue or main language: fill in the blank
Second language: fill in the blank
Any other languages you know: fill in the blank
Please confirm that you are available to actively participate in the GNR Stakeholder Group.*

Yes, as a memberYes, also happy to serve as Co-Chair
Which of the following constituencies do you represent? You may select more than one.*

Governments, public institutions, policy, or academic institutions from the Global SouthDonorsUN organisationsCivil societyBusiness association or other group with experience in influencing private sector behaviours to improve nutritionYouthOther
Please describe how you are a good candidate to represent the selected constituencies in advising the GNR.*
Please provide a short statement of 500 words or less describing your background and expertise and how you will bring value to the work of the SG as set out in the Terms of Reference.
Statement*

0/500
Please provide a draft biography of 175 words or less that you would propose we use to describe you on the Stakeholder Group page of the GNR website, if you are selected.{pleaseWrite}
Biography

0/175
Any other information relevant to your application.

Protection of personal data
GNR takes the protection of the privacy and security of your personal information very seriously. We collect and use personal information about you, in accordance with the General Data Protection Regulation (GDPR). We will only retain your personal information for as long as necessary to fulfil the purposes we collected it for, including for the purposes of satisfying any legal, accounting, or reporting requirements. We have put in place measures to protect the security of your information as set forth in the hosting organisation’s privacy notice. Details of these measures are available upon request.
Conflicts of Interest
Avoiding conflicts of interest is important to the GNR. For transparency and appropriate management, all potential SG members must declare any potential conflict of interest (COI) ahead of acceptance into the SG. Any COI that may arise during the candidate's period as an SG member will be managed by the SG Co-Chairs and the Independent Expert Group Chair.

Conflicts are not only financial in nature but may also arise if an SG member takes a position or supports another organisation that is counter to GNR's mission and values.
COI declaration*

I have no actual nor potential conflict of interest to report.I have the following actual or potential conflict of interest to report.
If applicable, please describe below any relationships, transactions, positions you hold (volunteer or otherwise), or circumstances that you believe could contribute to a conflict of interest.
I confirm that the information I have provided is correct. I understand that any misrepresentation in supplying this information may lead to my exclusion from the present Call.
Signature*

Clear
Should be Empty:

GNR Stakeholder Group Application

Protection of personal data

Conflicts of Interest