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: | Maryam Bakoshi | Date: | 15-Apr-2016 |
| Application Status | Assessment Due-Date | Form ID # |
| CANCELLED | 15-Jul-2016 | NCUC04 |
Trip Proposal Section | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1) Number of Travelers: | 1 | ||||||||||||
2) Traveler Contact Information and Itinerary:
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| 3) Special Travel Circumstances, Arrangements, Explanations, or Notations: (Please identify each traveler, as applicable) | |||||||||||||
| 4) Event/Conference Name, Title, or Descriptor: | CSISAC Forum & OECD Ministerial Conference 2016 | ||||||||||||
| 5) Event/Conference Dates: |
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| 6) Event/Conference Website Link: | http://csisac.org/events/cancun16/ | ||||||||||||
| 7) Primary Event/Conference Location: |
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| 8) ICANN Geographic Region: | Latin America and Caribbean | ||||||||||||
9) Activity Sponsors: |
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10) Proposed Goals and Outcomes: | The theme "Digital Economy" is totally within the scope of the ICANN and NCUC mission and being this a specific forum for Civil Society to interact it is completely related to NCUC's work. | ||||||||||||
| 11) Additional Information (optional): | |||||||||||||
| ======================================= | |||||||||||||
Note: To be completed by a Pilot Program Coordinator (PPC) designated by this organization/structure.
| Acknowledgements | Confirmed? | Name | Date | Notes |
|---|---|---|---|---|
| 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. | Yes | Rafik Dammak | 15-Apr-2016 | |
| The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal. | Yes | 15-Apr-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. | ||||
| =============== | ========== | ============================== |
Approved Travel Elements:
| Traveler | Approved Arrival Date | Approved Departure Date | Approved Fees |
|---|---|---|---|
|
Staff Department Notifications:
| Program Requirement | Date Satisfied/Confirmed | Initials | Notes |
| Program Criteria Satisfied | BR | Traveller cancelled the trip due to unforeseen circumstances. Trip proposal was cancelled. |
Program Admin Transfers from Community Drafts to Approved Forms: | |||
|---|---|---|---|
| Trip Proposal | Trip/Event Assessment | ||
CROPP Trip Proposal Template v4 (Aug 2015)
