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.

Outreach/Engagement Event Proposals must be completed at least eight (8) weeks before the event start date.

Person Completing Form
Name: Date Submitted:

Form ID #



Event Proposal Section

1) Which GNSO structure is submitting this request:

2) Who will be the principal liaison assigned
to work with Communications:
Name: Email:



3) Event Title or Descriptor:
4) Preferred Event Dates:
(Note: Due to the extensive Staff support and logistical planning associated with events, advanced scheduling and reservations may be required to ensure that (a) only one such event occurs at the same time, and (b) there are no overlaps with other scheduled events such as ICANN Public Meetings).
5) Primary Event/Conference Location:
City: Country:
6) ICANN Geographic Region:

7) Proposed Goals and Outcomes for this Event:
(Note: Please address linkages to the Outreach Strategic Plan). 



8) Additional Information (optional):


Community Confirmation Section

Note: To be completed by a Pilot Program Coordinator (PPC) designated by this organization/structure.

The Engagement Event goals, dates, and other requirements have been negotiated with applicable ICANN Staff departments and approved as documented above.

The ICANN Organization / Structure's leadership has authorized the submission of this Engagement Event Proposal.

The ICANN Stakeholder Engagement Vice-President has concurred that the Goals/Outcomes of this Engagement Event Proposal are consistent with operational plans and/or strategies.

Program Administration: STAFF USE ONLY
Program RequirementDate Satisfied/ConfirmedInitialsNotes

Event Proposal Confirmed and
Transferred to Approved Forms: 
Event Assessment Confirmed and
Transferred to Approved Forms: 

CROPP Outreach Engagement Event Template v2 (May 2015)

For comments, suggestions, or technical support concerning this space, please email: CROPP Program Staff
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