Instructions:
1. You must be logged in to the Community Wiki with a valid Username and Password in order to complete forms within CROP.
2. Your organization must first complete and get approval for the Outreach Strategic Plan before any CROP trip could be processed.
3. There are two CROP forms required for each Trip: a) a Trip Proposal; b) a Trip Assessment (must be complete within three (3) weeks of all travelers having returned from the event, no later than the assessment due date which is automatically calculated based on the trip return date).
4. Multiple travelers are asked to collaborate as a team in pulling together the appropriate information.
5. To fill out the the form, click 
(top of the screen)
6. Answer each of the questions that appears within the form. Use the scroll bar (right) to reveal all contents. Click here to read the full instructions
IMPORTANT: This form must be completed by the traveler him/herself.
| Person Completing Form | |||
|---|---|---|---|
| Name: | Laïcana | Date: | 02-May-2019 |
Application |
APPROVED |
Trip Proposal Section | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1) Traveler Contact Information and Itinerary:
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| 2) Special Travel Circumstances, Arrangements, Explanations, or Notations: (Please identify each traveler, as applicable) | |||||||||||||
| 3) Event/Conference Name, Title, or Descriptor: | ICANN65, MARRAKECH, MOROCCO | ||||||||||||
| 4) Event/Conference Dates: |
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| 5) Event/Conference Website Link: | |||||||||||||
| 6) Primary Event/Conference Location: |
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| 7) ICANN Global Stakeholder Engagement Region: | Africa | ||||||||||||
8) Activity Sponsors: | - VeriSign - CentralNic - Afilias - Your Public Interest Registry | ||||||||||||
9) Proposed Goals and Outcomes: Content Guidelines (click here) | 1) ENGAGING WITH OTHER ICANN65 ATTENDEES AND INTRODUCING THE BC AND OUR PURPOSE/ACTIVITIES, ETC. TO THOSE WHO VISIT THE BOOTH. 1B) DISTRIBUTE THE BC NEWSLETTER AND BC FACTSHEET IN THE BOOTH AND IN OTHER INFORMAL DISCUSSIONS YOU PARTICIPATE IN TO HELP TO BROADEN AWARENESS OF ICANN 2)ATTENDING ICANN65 AND PARTICIPATING IN THE VARIOUS HIGH LEVEL SESSIONS/WORKING SESSIONS OF THE BC AND CSG WILL ASSIST IN FURTHER ENGAGEMENT IN ACTIVITIES IN AFRICA/COTE D'IVOIRE. 3)COLLABORATE WITH THE BC OUTREACH COMMITTEE AND THE BC EXECOM TO REACH OUT TO THOSE FELLOWS ATTENDING ICANN65 WHO ARE IDENTIFIED AS “BUSINESS” TO INCLUDE THEM IN THE BC’S AND CSG OPEN MEETINGS WITH INFORMAL INTRODUCTIONS 3B) ENCOURAGE MORE AWARENESS OF ICANN’S FELLOWSHIP AND NEXTGEN PROGRAMS ACTIVELY ATTEND AND PARTICIPATE IN THE WHOIS ACCESS DISCUSSION AND UNIVERSAL ACCESS 3C)ATIVELY SUPPORT AND PARTICIPATE IN THE JOINT CSG OUTREACH EVENT DURING ICANN65 TO ENGAGE WITH PARTICIPANTS. [IN COLLABORATION WITH THE ICANN OUTREACH COMMITTEE AND BC EXCOM] 5) MY PLAN IS TO IDENTIFY OPPORTUNITIES TO INTRODUCE ICANN AND THE BC PRIORITIES to GOTIC and CLUB DES DSI IN COTE D'IVOIRE | ||||||||||||
| 10) Additional Information (optional): | |||||||||||||
11) Consent & Authorization: By submitting my personal data, I agree that my personal data will be processed in accordance with the ICANN Privacy Policy, and agree to abide by the website Terms of Service. If you agree to text above, please fill out your name and date in the box on the right. |
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| _______________________________________________________________ | |||||||||||||
Note: The first three elements below should be completed by a Program Coordinator (PC) designated by this organization/structure.
| Acknowledgements | Confirmed? | Who Confirmed? | Date of Confirmation | Notes |
|---|---|---|---|---|
| The participants identified in this application agree to abide by the terms and conditions of this FY18 Community Regional Outreach Program (CROP) as outlined on the CROP Procedures & Guidelines page. | Yes | Maryam Bakoshi | 07-May-2019 | |
| The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal. | Yes | BC Excomm | 07-May-2019 | |
| 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 | Pierre Danjinou | 07-May-2019 | |
| The CROP Staff Administrators confirm that this trip satisfies the program's terms, guidelines, and policies. | Yes | Maryam Bakoshi | 07-May-2019 | |
| =============== | ========== | ============================== |
Approved Travel Elements:
| Traveler | Approved Arrival Date | Approved Departure Date | Approved Fees |
|---|---|---|---|
Laïcana Coulibaly | 24-Jun-2019 | 27-Jun-2019 | Airfare |
Staff Department Notifications:
| Program Requirement | Date Satisfied/Confirmed | Staff Name | Notes |
Program Criteria Satisfied | 07-May-2019 | Maryam Bakoshi | |
Constituency Travel Notified | 07-May-2019 | Maryam Bakoshi | |
Travel Booking Initiated with Attendees | 07-May-2019 | Joseph de Jesus | New Traveler. Needs to complete information at https://travelrequestform.icann.org/ |
CROP Trip Proposal Template (June 2018)
