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
Name:Chantelle DoerksenDate:

16-Mar-2016

STAFF USE ONLY
Application
Status 
Assessment
Due-Date 
Form ID #
NOT APPROVED

04-May-2016

ISPC01

Trip Proposal Section

LINK:  ISPC Trip/Event Assessment 1 DRAFT

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
Anthony Harrisanthonyrharris@gmail.comBuenos AiresArgentina09-Apr-201613-Apr-2016
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
4) Event/Conference Name, Title, or Descriptor:Global Peering Forum; Hollywood L.A.
5) Event/Conference Dates:
Start:11-Apr-2016End:12-Apr-2016
6) Event/Conference Website Link:
7) Primary Event/Conference Location:
Street
Address:
1755 Highland Ave.
City:Los AngelesCountry:USA
8) ICANN Geographic Region:North America

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


10) Proposed Goals and Outcomes:

Meet with Decision makers from global ISPs, CDNs, cloud and interconnection service providers.
11) Additional Information (optional):

======================================= 
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 agree to abide by the terms and conditions of this FY16 Community Regional Outreach Pilot Program (CROPP) as outlined on the Program Elements page. YesChantelle Doerksen17-Mar-2016Confirmed, as per Christian Dawson and ISPCP leadership
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.YesChantelle Doerksen17-Mar-2016Confirmed, as per Christian Dawson, Tony Holmes, and ISPCP leadership
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.NoBenedetta Rossi21-Mar-2016This trip request does not meet the 6-week CROPP program requirement, nor the regional requirement.
  =======================================================
Program Administration: STAFF USE ONLY

Approved Travel Elements:

TravelerApproved
Arrival Date
Approved
Departure Date
Approved Fees 

Staff Department Notifications:

Program RequirementDate Satisfied/ConfirmedInitialsNotes

Program Admin Transfers from Community Drafts to Approved Forms:

Trip Proposal  Trip/Event Assessment


CROPP Trip Proposal Template v4 (Aug 2015)

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