Formulario de Incompatibilidades y Capacidades EN

Candidate Questionnaire

Incompatibilities and Capabilities
Full name*
Email address*
example@example.com

II. Criteria or rules for interpreting the incompatibility which states that no more than one member of the elected body may be an employee, consultant, or advisor of the same Company or Organization and/or of one of its Related Companies, whether established in the same country or not
Please specify the organization (or organizations) with which you have ties as an employee, consultant, or advisor. If they are part of (or controlled by) a business group, please specify.
Please specify whether the relationship is in a paid or honorary capacity.*

In a paid capacity (relationships where one party pays a salary and/or offers a significant financial benefit to another)In an honorary capacity (relationships where the person is not paid a salary and does not receive any other financial benefits. Per diem and/or the reimbursement of reasonable expenses are not considered financial benefits)I am not related to any organizationIf you specified a second organization, please specify whether the relationship is in a paid or honorary capacity:In a paid capacity (relationships where one party pays a salary and/or offers a significant financial benefit to another)In an honorary capacity (relationships where the person is not paid a salary and does not receive any other financial benefits. Per diem and/or the reimbursement of reasonable expenses are not considered financial benefits)
If you specified a third organization, please specify whether the relationship is in a paid or honorary capacity.

In a paid capacity (relationships where one party pays a salary and/or offers a significant financial benefit to another)In an honorary capacity (relationships where the person is not paid a salary and does not receive any other financial benefits. Per diem and/or the reimbursement of reasonable expenses are not considered financial benefits)

	Yes	No
Any limitation of your civil rights in the country specified in question 3 of Criterion I of this questionnaire.
Any fiscal or legal impediment to conduct acts of commerce in any country.

	Yes	No
Any health limitation that prevents you from traveling where needed to fulfill your role and travel as many times as necessary, even flying more than 10 continuous hours.
Any limitations that prevent you from making full use of your mental faculties, and not subject to any interdiction, guardianship, or curatorship arrangements.

Candidate Questionnaire

I. Criteria or rules for interpreting the incompatibility which states that no more than one or two members of an elected body may be citizens of the same country of the Region

If you have ties to a country of which you are not a citizen, please specify.

Please specify which of the above citizenships you would like to be considered for the purpose of Article 24 of the LACNIC Bylaws*

II. Criteria or rules for interpreting the incompatibility which states that no more than one member of the elected body may be an employee, consultant, or advisor of the same Company or Organization and/or of one of its Related Companies, whether established in the same country or not

Please specify the organization (or organizations) with which you have ties as an employee, consultant, or advisor. If they are part of (or controlled by) a business group, please specify.

III. Mandatory Competence Criteria

Legal

Health

Please provide the following information about the two LACNIC members supporting this nomination:

1) First expression of support:

2) Second expression of support: