Instructions:
1. You must be logged in to the Community Wiki with a valid Username and Password in order to complete forms within CROP.
2. Your organization must first complete and get approval for the Outreach Strategic Plan before any CROP trip could be processed.
3. There are two CROP forms required for each Trip: a) a Trip Proposal; b) a Trip Assessment (must be complete within three (3) weeks of all travelers having returned from the event, no later than the assessment due date which is automatically calculated based on the trip return date).
4. Multiple travelers are asked to collaborate as a team in pulling together the appropriate information.
5. To fill out the the form, click 
(top of the screen)
6. Answer each of the questions that appears within the form. Use the scroll bar (right) to reveal all contents. Click here to read the full instructions
IMPORTANT: This form must be completed by the traveler him/herself.
| Person Completing Form | |||
|---|---|---|---|
| Name: | Obed Sindy | Date: | 15-Jan-2020 |
Application |
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Trip Proposal Section | |||||||||||||
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1) Traveler Contact Information and Itinerary:
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| 2) Special Travel Circumstances, Arrangements, Explanations, or Notations: (Please identify each traveler, as applicable) | I’ve been selected several times to participate in ICANN but visa issues keep getting to the end.
Now I have a Canadian visa which will undoubtedly be able to favor my entry to Mexico for this meeting so although alternate, I believe that it will be a great opportunity to activate me in the activities of ICANN in my country and help me to better understand NPOC subjects so that I can make myself available for calls to volunteers and reconnect with the community.
One of my big challenge is to meet physically with members of the ICANN community and identify political ideas to take over in LAC region.
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| 3) Event/Conference Name, Title, or Descriptor: | ICANN 67 | ||||||||||||
| 4) Event/Conference Dates: |
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| 5) Event/Conference Website Link: | |||||||||||||
| 6) Primary Event/Conference Location: |
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| 7) ICANN Global Stakeholder Engagement Region: | Latin America and Caribbean | ||||||||||||
8) Activity Sponsors: | |||||||||||||
9) Proposed Goals and Outcomes: Content Guidelines (click here) | Engagement/Outreach including broadening awareness of ICANN in Haiti with webinars about fellowships, ICANN Mission... | ||||||||||||
| 10) Additional Information (optional): | |||||||||||||
11) Consent & Authorization: By submitting my personal data, I agree that my personal data will be processed in accordance with the ICANN Privacy Policy, and agree to abide by the website Terms of Service. If you agree to text above, please fill out your name and date in the box on the right. |
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| _______________________________________________________________ | |||||||||||||
Note: The first three elements below should be completed by a Program Coordinator (PC) designated by this organization/structure.
| Acknowledgements | Confirmed? | Who Confirmed? | Date of Confirmation | Notes |
|---|---|---|---|---|
| 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. | ||||
| The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal. | ||||
| 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. | ||||
| The CROP Staff Administrators confirm that this trip satisfies the program's terms, guidelines, and policies. | ||||
| =============== | ========== | ============================== |
Approved Travel Elements:
| Traveler | Approved Arrival Date | Approved Departure Date | Approved Fees |
|---|---|---|---|
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Staff Department Notifications:
| Program Requirement | Date Satisfied/Confirmed | Staff Name | Notes |
CROP Trip Proposal Template (June 2018)
