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Trip Proposal Section

1) Number of Travelers:
(Note: Each traveler uses one trip of the five (5) allocated to each organization/structure).  

Number Data
width
minValue1
maxValue5
width100px
nameTRIPS
100pxformat###
 

2) Traveler Contact Information and Itinerary:

Table Data
nameCONTACTINFO
initialRows1
TravelerEmailFrom
City
From
Country
Depart
Date
Return
Date
textTRAVELER1BLOCKline

 

T-EMAILBLOCKline

 

textFROM1BLOCKline

 

textFROM2BLOCKline

 

DEPARTdd-MMM-yyyyBLOCKRETURNdd-MMM-yyyyBLOCK
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
Text Data
width650px
nameSPECIALwidth650px
contenttext

 

4) Event/Conference Name, Title, or Descriptor:
Text Data
nameEVENT
contenttext

 

5) Event/Conference Dates:
Start:
Date Data
nameSTART
formatdd-MMM-yyyy
 
End:
Date Data
nameEND
formatdd-MMM-yyyy
 
6) Event/Conference Website Link:
Text Data
nameLINK

 

7) Primary Event/Conference Location:
Street
Address:
Text Data
nameADDRESS
contenttext

 

City:
Text Data
nameCITY
typeline
contenttext

 

Country:
Text Data
nameCOUNTRY
typeline
contenttext

 

8) ICANN Geographic Region:
List Data
nameREGION
AfricaA

 

AsiaB

 

Australasia/Pacific IslandsC

 

EuropeD

 

Latin America and CaribbeanE

 

Middle EastF

 

North AmericaG

 

Russia/CIS/Eastern EuropeH

 

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


Text Data
nameSPONSORS

 

10) Purpose and Goals:

Text Data
namePURPOSE
contenttext
 

11) Proposed Outcomes:
Text Data
nameOUTCOMES
contenttext

 

12) Additional Information (optional):

Text Data
nameADDTLINFO
 

Panel
titleColornavy
titleBGColorlightyellow
titleCommunity 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 are familiar with the Program Operations associated with this Community Regional Outreach Pilot Program (CROPP)-FY15 and agree to abide by its terms and conditions.
List Data
nameACK-1
YesA

 

NoB

 

Text Data
nameACKNAME-1
typeline
contenttext

 

Date Data
nameACKDATE-1
formatdd-MMM-yyyy
 
Text Data
width
width300px
nameACKNOTES-1
300pxcontenttext

 

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

 

NoB

 

Text Data
nameACKNAME-2
typeline
contenttext

 

Date Data
nameACKDATE-2
formatdd-MMM-yyyy
 
Text Data
width300px
nameACKNOTES-2width300px
contenttext
 
The ICANN Stakeholder Engagement Vice-President has concurred that the Purpose/Goals of this Trip Proposal are consistent with operational plans and/or strategies.
List Data
nameACK-3
YesA

 

NoB

 

Text Data
nameACKNAME-3
typeline
contenttext
 
Date Data
nameACKDATE-3
formatdd-MMM-yyyy
 
Text Data
width300px
nameACKNOTES-3width300px
contenttext
 
  =======================================================

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Panel
bgColorlightyellow
titleColormaroon
titleBGColorlightcyan
titleProgram Administration: STAFF USE ONLY
Table Data
nameREQUIREMENTS
initialRows1
Program RequirementDate Satisfied/ConfirmedInitialsNotes
RQMTBLOCKSpeakers BureauA

 

Communications DepartmentB

 

Meetings TeamC

 

Constituency Travel NotifiedD

 

Travel BookedE Program Criteria SatisfiedF 
SATISFIEDdd-MMM-yyyyBLOCK50pxINITIALSBLOCKJDLA

 

RHB

 

text300pxNOTESBLOCK

 

Trip Proposal Approved and
Transferred to Official Forms: 
Date Data
nameP-POSTED
formatdd-MMM-yyyy
 
Trip Assessment Approved and
Transferred to Official Forms: 
Date Data
nameA-POSTED
formatdd-MMM-yyyy
 

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