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Info

Instructions:

  1. Please use the <Edit Contents> menu option (directly above) to complete this form. Remember to <Save> the page (bottom right) after making updates.
  2. Multiple travelers are asked to collaborate as a team in pulling together the appropriate information.
  3. Some information fields are 'richtext' so that they can accommodate tables, links, images, attachments, and other formatting capabilities that may be useful in explaining/describing this proposal.
  4. This form may be edited/saved as many times as needed. When completed, please notify your Program Coordinator (PC) for further processing.


Note

Trip Proposals must be approved within the Organization/Structure and Regional GSE Team at least six (6) weeks before the event start date.
Questions about this program should be directed to: CROP Staff.


Person Completing Form
Name:


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namePERSON
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contenttext

 


Date:


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formatdd-MMM-yyyy
nameAPPDATE
now




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titleSTAFF USE ONLY


Application
Status 
Assessment
Due-Date 


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nameSTATUS
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Report Info
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data:END > shift + 22d
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Trip Proposal Section

LINK TO TRIP ASSESSMENT:  APRALO Trip Assessment 1 DRAFT

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


Number Data
minValue1
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format###
nameTRIPS
width100px
 


2) Traveler Contact Information and Itinerary:

Table Data
nameCONTACTINFO
initialRows1


TravelerEmailFrom
City
From
Country
Depart
Date
Return
Date


TRAVELER1linetextBLOCK

 



T-EMAILlineBLOCK

 



FROM1linetextBLOCK

 



FROM2linetextBLOCK

 



01-Jul-2017dd-MMM-yyyyDEPARTBLOCK



dd-MMM-yyyyRETURN30-Jun-2018BLOCK




3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)


Text Data
nameSPECIAL
width650px
contenttext

 


4) Event/Conference Name, Title, or Descriptor:


Text Data
nameEVENT
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5) Event/Conference Dates:


Start:


Date Data
formatdd-MMM-yyyy
nameSTART
 


End:


Date Data
formatdd-MMM-yyyy
nameEND
 



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 Global Stakeholder Engagement Region:


List Data
nameREGION


AAfrica

 


BAsia

 


CAustralasia/Pacific Islands

 


DEurope

 


ELatin America and Caribbean

 


FMiddle East

 


GNorth America

 


HEastern Europe and Central Asia

 



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



Text Data
nameSPONSORS

 


10) Proposed Goals and Outcomes:

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Content Guidelines (click here)

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Please develop specific goals/outcomes for as many of the following categories as applicable:

1) Workshops/Seminars/Presentations including roles (e.g., speaker, facilitator, organizer), relevant content, literature to be disseminated, and specific purposes/objectives.

2) Engagement/Outreach including broadening awareness of ICANN in targeted regional areas (e.g., under-represented).

3) Recruitment including formal/informal invitations to become involved in ICANN stakeholder communities, working groups, and/or fellowship programs.

4) Fulfillment of documented Outreach Strategic Plans and/or ICANN Regional Strategies.

5) Knowledge Sharing including intentions to extend learnings within and among ICANN stakeholder communities.


 


Text Data
nameGOALS

 


11) Additional Information (optional):


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nameADDTLINFO
 


_______________________________________________________________ 


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Note: The first three elements below should be completed by a Program Coordinator (PC) designated by this organization/structure.

AcknowledgementsConfirmed?NameDateNotes
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.


List Data
nameACK1


AYes

 


BNo

 




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nameACKNAME1
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contenttext

 



Date Data
formatdd-MMM-yyyy
nameACKDATE1
 



Text Data
nameACKNOTES1
width300px
contenttext

 


The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.


List Data
nameACK2


AYes

 


BNo

 




Text Data
nameACKNAME2
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contenttext

 



Date Data
formatdd-MMM-yyyy
nameACKDATE2
 



Text Data
nameACKNOTES2
width300px
contenttext
 


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.


List Data
nameACK3


AYes

 


BNo

 




Text Data
nameACKNAME3
typeline
contenttext
 



Date Data
formatdd-MMM-yyyy
nameACKDATE3
 



Text Data
nameACKNOTES3
width300px
contenttext
 


The CROP Staff Administrators confirm that this trip satisfies the program's terms, guidelines, and policies.


List Data
nameACK4


AYes

 


BNo

 




Text Data
nameACKNAME4
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contenttext
 



Date Data
formatdd-MMM-yyyy
nameACKDATE4
 



Text Data
nameACKNOTES4
width300px
contenttext
 


  =======================================================



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titleProgram Administration: STAFF USE ONLY

Approved Travel Elements:

Table Data
nameTRAVELAPPROVAL
initialRows1


TravelerApproved
Arrival Date
Approved
Departure Date
Approved Fees 


ATRAVELERlinetextBLOCK

 



dd-MMM-yyyyADEPARTBLOCK



dd-MMM-yyyyARETURNBLOCK



trueFUNDEDchecknewlineINLINE


AAirfare

 


BHotel/Lodging

 


CPer Diem

 


DVisa

 


ERegistration

 




Staff Department Notifications:

Table Data
nameREQUIREMENTS
initialRows1


Program RequirementDate Satisfied/ConfirmedInitialsNotes


RQMTBLOCK


ASpeakers Bureau

 


BCommunications Department

 


CMeetings Team

 


DConstituency Travel Notified

 


ETravel Booking Initiated with Attendees 


FTravel Booking Completed/Confirmed 


GProgram Criteria Satisfied 


HOther Disposition 




dd-MMM-yyyySATISFIEDBLOCK



INITIALS50pxBLOCK



BMW

 


CBR

 


EJDJ

 


FAL

 


GOS

 




NOTES300pxtextBLOCK

 




Program Admin Transfers from Community Drafts to Approved Forms:

Trip Proposal


Date Data
formatdd-MMM-yyyy
namePPOSTED
 


Trip Assessment


Date Data
formatdd-MMM-yyyy
nameAPOSTED
 




CROP Trip Proposal Template (May 2017)