Please use the <Edit Contents> menu option (directly above) to complete this form. Remember to <Save> the page (bottom right) after making updates. Other than the two required fields immediately below, you may complete any portion of this form, save, and return later to continue where you left off.

Trip Proposals must be completed at least six (6) weeks before the event start date.

Person Completing Form
Name:Alberto SotoDate:

01-Mar-2016

STAFF USE ONLY
Application
Status 
Assessment
Due-Date 
Form ID #
WITHDRAWN

14-May-2016

LAC01

Trip Proposal Section

LINK: LACRALO Trip/Event Assessment 1 DRAFT

1) Number of Travelers:
(Note: Each traveler uses one trip of the five (5) allocated to each organization/structure).  

1

2) Traveler Contact Information and Itinerary:

TravelerEmailFrom
City
From
Country
Depart
Date
Return
Date
Derisma Queslin queslinderisma@yahoo.frPrince PortHaiti20-Apr-201623-Apr-2016
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
None
4) Event/Conference Name, Title, or Descriptor:CaribNOG's 11th Regional Gathering in Montego Bay, Jamaica
5) Event/Conference Dates:
Start:20-Apr-2016End:22-Apr-2016
6) Event/Conference Website Link:http://www.caribnog.org/
7) Primary Event/Conference Location:
Street
Address:
Half Moon Resort, Rose Hall
City:Montego BayCountry:Jamaica
8) ICANN Geographic Region:Latin America and Caribbean

9) Activity Sponsors:
(Note: all event sponsors must be identified
in order to comply with ICANN travel guidelines).


Caribbean Telecommunications Union (CTU), the American Registry for Internet Numbers (ARIN), the Packet Clearing House (PCH) and The BrightPath Foundation.

10) Proposed Goals and Outcomes:

Allow the assistant to a country very lacking in communications, take a view on the region, contacting the various sponsors. For disseminating including the activities and needs of your ALS, LACRALO and ICANN.
11) Additional Information (optional):

======================================= 
Community Confirmation Section

Note: To be completed by a Pilot Program Coordinator (PPC) designated by this organization/structure.

AcknowledgementsConfirmed?NameDateNotes
The participants identified in this application agree to abide by the terms and conditions of this FY16 Community Regional Outreach Pilot Program (CROPP) as outlined on the Program Elements page. YesDev Anand Teelucksingh09-Mar-2016Participant has been emailed and will follow up with him to ensure compilance
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.YesDev Anand Teelucksingh09-Mar-2016
The ICANN Stakeholder Engagement Vice-President has concurred that the Proposed Goals/Outcomes of this Trip Proposal are consistent with operational plans and/or strategies.YesDev Anand Teelucksigh09-Mar-2016
  =======================================================
Program Administration: STAFF USE ONLY

Approved Travel Elements:

TravelerApproved
Arrival Date
Approved
Departure Date
Approved Fees 
Derisma Queslin 20-Apr-201623-Apr-2016

Airfare
Hotel/Lodging
Per Diem

Staff Department Notifications:

Program RequirementDate Satisfied/ConfirmedInitialsNotes
Meetings Team09-Mar-2016JDLJoseph can move forward with this approved traveller; no addt'l fees requested beyond flight, hotel and per diem
Program Criteria Satisfied JDLThe traveller was unable to secure a US VISA in time for the trip and therefore the travel to CaribNOG did not take place.

Program Admin Transfers from Community Drafts to Approved Forms:

Trip Proposal Trip/Event Assessment


CROPP Trip Proposal Template v4 (Aug 2015)

For comments, suggestions, or technical support concerning this space, please email: CROPP Program Staff
© 2015 Internet Corporation For Assigned Names and Numbers