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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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Date:


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nameAPPDATE
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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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Trip Proposal Section

LINK TO TRIP ASSESSMENT :  APRALO Trip Assessment 6

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


Number Data
minValue1
maxValue5
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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-yyyyDEPART30-JUN-2018BLOCK



01-JUL-2017dd-MMM-yyyyRETURN30-JUN-2018BLOCK




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


Text Data
nameSPECIAL
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contenttext



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


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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:


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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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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.


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nameACK1


AYes



BNo





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nameACKNAME1
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Date Data
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nameACKDATE1
 



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nameACKNOTES1
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The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.


List Data
nameACK2


AYes



BNo





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nameACKNAME2
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contenttext




Date Data
formatdd-MMM-yyyy
nameACKDATE2
 



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nameACKNOTES2
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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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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)