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:

15-Apr-2016

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

02-Jul-2016

ISPC04

Trip Proposal Section

LINK:  ISPC Trip/Event Assessment 4

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
Leonard Obonyoleonard@tespok.co.keNairobi Kenya03-Jun-201605-Jun-2016
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
Fiona Asonga (ISPCP Member) will also attend, but is funded through her organization.
4) Event/Conference Name, Title, or Descriptor:Africa Internet Summit (AFRINIC-24)
5) Event/Conference Dates:
Start:29-May-2016End:10-Jun-2016
6) Event/Conference Website Link:https://internetsummitafrica.org
7) Primary Event/Conference Location:
Street
Address:
City:GabroneCountry:Botswana
8) ICANN Geographic Region:Africa

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



List of complete sponsors for AIS'16 currently not available on-line; these were the sponsors from AIS'15.

10) Proposed Goals and Outcomes:

The participants include ISPs, Network and Connectivity providers to whom we can reach out to attend the ICANN Meetings and participate in the ISPCP Constituency. On Saturday 4th June there is the ICANN Day and we can request the ICANN Team to give us an opportunity to present on what ISPCP is doing at ICANN.
11) Additional Information (optional):

Fiona Asonga will also attend using her organization's support.

======================================= 
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 Doerksen15-Apr-2016Per Christian Dawson (ISPCP CROPP Coordinator) and ISPCP Leadership
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.YesChantelle Doerksen15-Apr-2016Per Christian Dawson (ISPCP CROPP Coordinator) 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.YesBenedetta Rossi18-Apr-2016Approved as per Pierre Dandjinou
  =======================================================
Program Administration: STAFF USE ONLY

Approved Travel Elements:

TravelerApproved
Arrival Date
Approved
Departure Date
Approved Fees 
Leonard Obonyo03-Jun-201605-Jun-2016

Airfare
Hotel/Lodging
Per Diem
Visa

Staff Department Notifications:

Program RequirementDate Satisfied/ConfirmedInitialsNotes
Constituency Travel Notified18-Apr-2016BR

Program Admin Transfers from Community Drafts to Approved Forms:

Trip Proposal19-Apr-2016Trip/Event Assessment01-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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