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 Doerksen

Date:

17-Mar-2016

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

APPROVED

27-May-2016

ISPC02

Trip Proposal Section

LINK:  ISPC Trip/Event Assessment 2

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 Harris

anthonyrharris@gmail.com

Buenos Aires

Argentina

01-May-2016

06-May-2016

3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
4) Event/Conference Name, Title, or Descriptor:

LACNIC 25

5) Event/Conference Dates:
Start:

02-May-2016

End:

05-May-2016

6) Event/Conference Website Link:

http://www.lacnic.net/en/web/eventos/lacnic25

7) Primary Event/Conference Location:
Street
Address:

Palacio de las Convenciones

City:

Havana

Country:

Cuba

8) ICANN Geographic Region:

Latin America and Caribbean

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


 

10) Proposed Goals and Outcomes:

A strategic event for the ISPCP to get many Telcos and ISPs from the LAC region to come to the ICANN meetings in Puerto Rico during this year.

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.

Yes

Chantelle Doerksen

17-Mar-2016

Confirmed, as per Christian Dawson and ISPCP leadership

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

Yes

Chantelle Doerksen

17-Mar-2016

Confirmed, as per Christian Dawson and Tony Holmes, with 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.

Yes

Benedetta Rossi

18-Mar-2016

Trip proposal supported by Rodrigo de la Parra. Hotel nights to be covered by ICANN: May 3-4.

  =======================================================
Program Administration: STAFF USE ONLY

Approved Travel Elements:

TravelerApproved
Arrival Date
Approved
Departure Date
Approved Fees 

Anthony Harris

03-May-2016

05-May-2016

Airfare
Hotel/Lodging
Per Diem

Staff Department Notifications:

Program RequirementDate Satisfied/ConfirmedInitialsNotes

Constituency Travel Notified

21-Mar-2016

BR

Constituency Travel team notified. Please note that ICANN funded hotel nights are May 3 and 4th.

Program Admin Transfers from Community Drafts to Approved Forms:

Trip Proposal 

22-Mar-2016

Trip/Event Assessment

01-Sep-2016


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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