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1. Name (Required.)

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2. Email (Required.)

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3. Confirm email (Required.)

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4. What are the most important issues or developments (three to five) in your country or area of interest for the Internet's evolution and Internet users over the next 3-5 years? (Please answer in 250 or fewer words.) (Required.)

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5. What actions could be taken by your organization or Chapter to address or respond to these issues? (Please answer in 250 or fewer words.) (Required.)

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6. What actions could be taken by the global Internet Society community and organisation to address or respond to these issues? (Please answer in 250 or fewer words.) (Required.)

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7. Are there any other factors the Internet Society Board of Trustees and executive team should consider as they prepare for the next 3-5 years? (Please answer in 250 or fewer words.) (Required.)

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