The following is a visual version of the Form for MAG 2018 Nominations, meaning that it is only a public template, not ready for submissions. Otherwise, the MAG 2018 Nomination Form itself is ready for submissions: You will need to login with your IGF community account in order to access it. ________________ Please note that this form is intended to be filled in by the nominator. If you are nominating yourself, please add your personal information in both the nominator and nominee fields. When the form is submitted, an email (containing the nominator's name and email address) is sent to the nominee asking her/him to accept the nomination. The nominator also receives an informative e-mail to confirm the good submission of the nomination proposal to the nominee. The nominee is required to accept the nomination, in order for it to be considered as a completed MAG 2018 Nomination. Note: If you use an abbreviation or acronym throughout this form, please spell out the term in the first instance and put the abbreviation/acronym in brackets. Deadline for nominations is 10 November 2017 Nominator Details Gender *- Select -FemaleMaleOther Family Name * Given Name * Organization * Job Title * E-mail * Contact Telephone (please indicate the country code) * Stakeholder Group *- Select -GovernmentCivil SocietyTechnical CommunityPrivate SectorNote: "Government" means "Representatives assigned by their respective Government". Regional Group *- Select -African GroupAsia-Pacific GroupEastern European GroupLatin American and Caribbean Group (GRULAC)Western European and Others Group (WEOG)International OrganizationTo find the explanation of the regional groups, please click here. Nominee Details Gender *- Select -FemaleMaleOther Family Name * Given Name * Other Names Organization(s) * Job Title(s) * Stakeholder Group *- Select -GovernmentCivil SocietyTechnical CommunityPrivate SectorNote: "Government" means "Representatives assigned by their respective Government". Regional Group *- Select -African GroupAsia-Pacific GroupEastern European GroupLatin American and Caribbean Group (GRULAC)Western European and Others Group (WEOG)To find the explanation of the regional groups, please click here. Nationality(ies) *AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBolivia, Plurinational State ofBosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCongo, Democratic Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly See (Vatican City State)HondurasHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedonia, The Former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyrian Arab RepublicTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamYemenZambiaZimbabwe Country of Residence *- Select -AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBolivia, Plurinational State ofBosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCongo, Democratic Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly See (Vatican City State)HondurasHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedonia, The Former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyrian Arab RepublicTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamYemenZambiaZimbabwe City of Residence * E-mail * Contact Telephone (please indicate the country code) * Background Information * Please, justify your nomination, providing relevant background information about the nominee (using no more than 300 words)