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:Tijani BEN JEMAADate:

31-Aug-2014

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

20-Dec-2014

AF03

Trip Proposal Section

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
Mohamed Tijani BEN JEMAAtijani.benjemaa@topnet.tnTunisTunisia20-Nov-201423-Nov-2014
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
4) Event/Conference Name, Title, or Descriptor:AFRINIC 21st Public Policy Meeting
5) Event/Conference Dates:
Start:22-Nov-2014End:28-Nov-2014
6) Event/Conference Website Link:

http://meeting.afrinic.net/afrinic-21/en/

 

7) Primary Event/Conference Location:
Street
Address:
Hennessy Park Hotel, Cybercity Ebene, Republic of Mauritius,
City:MauritiusCountry:Mauritius
8) ICANN Geographic Region:Africa

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


Microsoft

10) Purpose and Goals:

1. Reaching out the African Internet community to find more African organizations to apply for AFRALO ALS certification 2. Providing information about the available 2015 NomCom positions for Africa and identifing potential candidates

11) Proposed Outcomes:More visibility for ICANN and AFRALO More ALS applications in the AFRALO region More members of African internet community informed about the available 2015 NomCom positions for Africa At least 2 potential candidates identified
12) Additional Information (optional):

Materials on 2015 NomCom positions will be provided by Fatimata, including hints for the identification of potential candidates from the region.

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 are familiar with the Program Operations associated with this Community Regional Outreach Pilot Program (CROPP)-FY15 and agree to abide by its terms and conditions.YesDev Anand Teelucksingh08-Sep-2014The CROPP-FY15 approved this application without any objection, 8 days after its submission
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.YesAziz Hilali03-Sep-2014
The ICANN Stakeholder Engagement Vice-President has concurred that the Purpose/Goals of this Trip Proposal are consistent with operational plans and/or strategies.YesPierre Dandjinou03-Sep-2014
  =======================================================

 


 

Program Administration: STAFF USE ONLY
Program RequirementDate Satisfied/ConfirmedInitialsNotes
Trip Proposal Approved and
Transferred to Official Forms: 
09-Sep-2014Trip Assessment Approved and
Transferred to Official Forms: 
06-Jan-2015


CROPP Application Template v8 (May 2014)

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