IPC Trip Proposal 1

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Trip Proposals must be completed at least six (6) weeks before the event start date.

Person Completing Form:	Brian J. Winterfeldt	Date:	10-Sep-2015

STAFF USE ONLY

Application Status	Assessment Due-Date	Form ID #
APPROVED	12-Nov-2015	IPC01

Trip Proposal Section

LINK: IPC Trip/Event Assessment 1

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:

Traveler	Email	From City	From Country	Depart Date	Return Date
Jenifer Casey	jenifer.casey@hsbc.com	Leeds	United Kingdom	19-Oct-2015	21-Oct-2015

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

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

ICANN 54

5) Event/Conference Dates:

Start:	19-Oct-2015	End:	21-Oct-2015

6) Event/Conference Website Link:

https://meetings.icann.org/en/dublin54

7) Primary Event/Conference Location:

Street Address:	The Convention Centre Dublin Spencer Dock North Wall Quay
City:	Dublin	Country:	Ireland

8) ICANN Geographic Region:

Europe

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

Sponsors

Gold

Silver

CNNIC - China Internet Network Information Center

Bronze

10) Proposed Goals and Outcomes:

Increased representation of Intellectual Property interests at ICANN 54 and outreach to potential new IPC members in the ICANN European region.

11) Additional Information (optional):

*Ms. Casey has confirmed that she will be responsible for any additional hotel and per diem charges during ICANN 54 that extend beyond the provided CROPP funding.

**ICANN Stakeholder Engagement Vice-President for the region has confirmed that the Purpose/Goals of this Trip Proposal are consistent with operational plans and/or strategies.

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Community Confirmation Section

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 agree to abide by the terms and conditions of this FY16 Community Regional Outreach Pilot Program (CROPP) as outlined on the Program Elements page.	Yes	Brian J. Winterfeldt	10-Sep-2015	I confirm that the participant has been informed of the terms and conditions of the FY16 CROPP and has agreed to abide by them.
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.	Yes	Brian J. Winterfeldt	10-Sep-2015	I confirm that IPC leadership has authorized the submission of this Trip Proposal.
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	Benedetta Rossi	11-Sep-2015	Jean-Jacques Sahel approved this request.
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Program Administration: STAFF USE ONLY

Approved Travel Elements:

Traveler	Approved Arrival Date	Approved Departure Date	Approved Fees
Jenifer Casey	19-Oct-2015	21-Oct-2015	Airfare Hotel/Lodging Per Diem

Staff Department Notifications:

Program Requirement	Date Satisfied/Confirmed	Initials	Notes
Program Criteria Satisfied	11-Sep-2015	BR
Constituency Travel Notified	11-Sep-2015	BR

Program Admin Transfers from Community Drafts to Approved Forms:
Trip Proposal	19-Nov-2015	Trip/Event Assessment	16-Dec-2015

CROPP Trip Proposal Template v4 (Aug 2015)

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