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> CROPP-FY14
> Outreach & Engagement: FY14 

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Trip Proposal Section

LINK TO TRIP ASSESSMENT : NCUC Trip Assessment 4 DRAFT

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


Number Data
minValue1
maxValue5
format###
nameTRIPS
width100px
 


2) Traveler Contact Information and Itinerary:

Table Data
nameCONTACTINFO
initialRows1


TravelerEmailFrom
City		From
Country		Depart
Date		Return
Date


TRAVELER1linetextBLOCK

 



T-EMAILlineBLOCK

 



FROM1linetextBLOCK

 



FROM2linetextBLOCK

 



01-Jul-2017dd-MMM-yyyyDEPARTBLOCK



dd-MMM-yyyyRETURN30-Jun-2018BLOCK




3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)


Text Data
nameSPECIAL
width650px
contenttext

 


4) Event/Conference Name, Title, or Descriptor:


Text Data
nameEVENT
contenttext

 


5) Event/Conference Dates:


Start:


Date Data
formatdd-MMM-yyyy
nameSTART
 


End:


Date Data
formatdd-MMM-yyyy
nameEND
 



6) Event/Conference Website Link:


Text Data
nameLINK

 


7) Primary Event/Conference Location:


Street
Address:


Text Data
nameADDRESS
contenttext

 


City:


Text Data
nameCITY
typeline
contenttext

 


Country:


Text Data
nameCOUNTRY
typeline
contenttext

 



8) Indicate whether it is a regional trip OR an out-of-region trip.



List Data
nameINOROUT


ARegional

 


BOut-of-region

 



9) ICANN Global Stakeholder Engagement Region:


List Data
nameREGION


AAfrica

 


BAsia

 


CAustralasia/Pacific Islands

 


DEurope

 


ELatin America and Caribbean

 


FMiddle East

 


GNorth America

 


HEastern Europe and Central Asia

 



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



Text Data
nameSPONSORS

 


11) Proposed Goals and Outcomes:

Toggle Cloak
Content Guidelines (click here)

Cloak


Please develop specific goals/outcomes for as many of the following categories as applicable:

1) Workshops/Seminars/Presentations including roles (e.g., speaker, facilitator, organizer), relevant content, literature to be disseminated, and specific purposes/objectives.

2) Engagement/Outreach including broadening awareness of ICANN in targeted regional areas (e.g., under-represented).

3) Recruitment including formal/informal invitations to become involved in ICANN stakeholder communities, working groups, and/or fellowship programs.

4) Fulfillment of documented Outreach Strategic Plans and/or ICANN Regional Strategies.

5) Knowledge Sharing including intentions to extend learnings within and among ICANN stakeholder communities.


 


Text Data
nameGOALS

 


12) Additional Information (optional):


Text Data
nameADDTLINFO
 


_______________________________________________________________ 

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