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Trip Assessment Form

1) Describe how the original Purpose and Goals were accomplished:

Text Data
name
namePURPOSE2
width600pxPURPOSE2
 

2) Describe how the original Outcomes were achieved:

 

Text Data
nameOUTCOMES2
width600pxnameOUTCOMES2

 

3) Date Completed:
Date Data
nameCOMPLETED
formatdd-MMM-yyyy
 
4) Additional information pertaining to this outreach event (optional):600px
Text Data
width
nameINFO-EVAL
width600px

 

Panel
titleColornavy
titleBGColorlightyellow
titleCommunity Confirmation Section

Note: To be completed by a Pilot Program Coordinator (PPC) designated by this organization/structure.

AcknowledgementsConfirmed?NameDateNotes
The Trip Assessment information has been gathered and properly entered into this form.
List Data
nameACK-1
YesA

 

NoB

 

Text Data
nameACKNAME-1
typeline
contenttext

 

Date Data
nameACKDATE-1
formatdd-MMM-yyyy
 
width
Text Data
300pxnameACKNOTES-1
width300px
contenttext

 

The ICANN Organization / Structure's leadership has authorized the submission of this Trip Assessment.
List Data
nameACK-2
YesA

 

NoB

 

Text Data
nameACKNAME-2
typeline
contenttext

 

Date Data
nameACKDATE-2
formatdd-MMM-yyyy
 
300px
Text Data
width
nameACKNOTES-2
width300px
contenttext
 
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