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: | Test Person | Date: | 27-May-2014 |
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| Application Status | Assessment Due-Date | Form ID # |
| PENDING | 30-Aug-2014 | SAMPLE |
Trip Proposal Section | |||||||||||||||||||
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1) Number of Travelers: | 2 | ||||||||||||||||||
2) Traveler Contact Information and Itinerary:
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| 3) Special Travel Circumstances, Arrangements, Explanations, or Notations: (Please identify each traveler, as applicable) | Susan is local to the event and does not require airfare/lodging reimbursement - only the registration fee. | ||||||||||||||||||
| 4) Event/Conference Name, Title, or Descriptor: | Conference name | ||||||||||||||||||
| 5) Event/Conference Dates: |
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| 6) Event/Conference Website Link: | http://www.conferencename.com | ||||||||||||||||||
| 7) Primary Event/Conference Location: |
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| 8) ICANN Geographic Region: | North America | ||||||||||||||||||
9) Activity Sponsors: | Sponsors:
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10) Purpose and Goals: | Purpose and goals described here... | ||||||||||||||||||
| 11) Proposed Outcomes: | Proposed outcomes documented here... | ||||||||||||||||||
| 12) 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 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. | Yes | PPC Name | 20-May-2014 | |
| The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal. | Yes | PPC Name | 21-May-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. | No | PPC Name | 22-May-2014 | Pending approval by Joe Catapano. |
| =============== | ========== | ============================== |
| Program Requirement | Date Satisfied/Confirmed | Initials | Notes |
| Trip Assessment Approved and Transferred to Official Forms: |
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CROPP Application Template v8 (May 2014)
