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Info

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.

Note

Trip Proposals must be completed at least six (6) weeks before the event start date.

Person Completing Form:
Text Data
namePERSON
typeline
contenttext
requiredtrue

 

Date:

Date Data
nameAPPDATE
formatdd-MMM-yyyy
requiredtrue
now

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bgColorwhite
titleColormaroon
titleBGColorlightcyan
titleSTAFF USE ONLY
Application
Status 
Assessment
Due-Date 
Form ID #
Text Data
nameSTATUS
typeline

 

Report Info
data:END > shift + 22d
data:END > shift + 22d
formatdd-MMM-yyyy

Status
colourBlue
titleAF06

Trip Proposal Section

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

Number Data
minValue1
maxValue5
width100px
nameTRIPS
format###
 

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
nameSPECIAL
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
 

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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
width300px
nameACKNOTES-1
contenttext

 

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-2
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-3
contenttext
 
  =======================================================

 


 

Panel
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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
 


CROPP Application Template v8 (May 2014)