Instructions:

1. You must be logged in to the Community Wiki with a valid Username and Password in order to complete forms within CROP.

2. Your organization must first complete and get approval for the Outreach Strategic Plan before any CROP trip could be processed.  

3. There are two CROP forms required for each Trip: a) a Trip Proposal; b) a Trip Assessment (must be complete within three (3) weeks of all travelers having returned from the event, no later than the assessment due date which is automatically calculated based on the trip return date).

4. Multiple travelers are asked to collaborate as a team in pulling together the appropriate information.

5. To fill out the the form, click  (top of the screen)

6. Answer each of the questions that appears within the form. Use the scroll bar (right) to reveal all contents. Click here to read the full instructions

IMPORTANT: This form must be completed by the traveler him/herself.

Person Completing Form
Name:

Viviane Gomes Vinagre

Date:

16-Jan-2020

STAFF USE ONLY

Application
Status 

CANCELLED

TRAVELER DEADLINE

Assessment Due Date

03-Apr-2020

Link to Trip Assessment

FY20 NCUC Trip Assessment 1

Trip Proposal Section

1) Traveler Contact Information and Itinerary:

TravelerEmailFrom
City
From
Country
Depart DateReturn Date
Viviane Gomes Vinagre
vivianegvinagre@gmail.com
São Paulo
Brazil
06-Mar-2020
15-Mar-2020
2) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
No special travel circumstances, arrangements or explanations or notations
3) Event/Conference Name, Title, or Descriptor:
ICANN 67 Cancun - Community Forum
4) Event/Conference Dates:
Start:
07-Mar-2020
End:
12-Mar-2020
5) Event/Conference Website Link:
6) Primary Event/Conference Location:
Street
Address:
Cancún International Convention Center MZ-48 L-08 office 2 1.N.Blvd. Kukulcan, Zona Hotelera, 77500 Cancun, Quintana Roo
City:
Cancun
Country:
Mexico
7) ICANN Global Stakeholder Engagement Region:
Latin America and Caribbean

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


9) Proposed Goals and Outcomes:

Content Guidelines (click here)

The ones already stated within the NCUC EC.
10) Additional Information (optional):

11) Consent & Authorization:

By submitting my personal data, I agree that my personal data will be processed in accordance with the ICANN Privacy Policy, and agree to abide by the website Terms of Service.

If you agree to text above, please fill out your name and date in the box on the right.


NameDate

Viviane Gomes Vinagre

16-Jan-2020

_______________________________________________________________
Acknowledgements Section

Note: The first three elements below should be completed by a Program Coordinator (PC) designated by this organization/structure.

AcknowledgementsConfirmed?Who Confirmed?Date of ConfirmationNotes
The participants identified in this application agree to abide by the terms and conditions of this FY18 Community Regional Outreach Program (CROP) as outlined on the CROP Procedures & Guidelines page.
Yes
M Bakoshi
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.
Yes
M Bakoshi
17-Jan-2020
On behalf of Bruna Martins - NCUC Chair
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.
Yes
M BAKOSHI
21-Jan-2020
ON BEHALF OF RODRIGO DE LA PARRA
The CROP Staff Administrators confirm that this trip satisfies the program's terms, guidelines, and policies.
Yes
M Bakoshi


=======================================================
Program Administration: STAFF USE ONLY

Approved Travel Elements:

TravelerApproved
Arrival Date
Approved
Departure Date
Approved Fees 
Viviane Gomes Vinagre
06-Mar-2020
09-Mar-2020

Airfare
Hotel/Lodging
Per Diem

Staff Department Notifications:

Program RequirementDate Satisfied/ConfirmedStaff NameNotes
Program Criteria Satisfied
17-Jan-2020
M Bakoshi
SELF FUNDED FROM NIGHT OF 9TH MARCH
Constituency Travel Notified
21-Jan-2020
M BAKOSHI
Travel Booking Initiated with Attendees
23-Jan-2020
Joseph de Jesus


CROP Trip Proposal Template (June 2018)