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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.

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

Person Completing Form:Evan LeibovitchDate:

31-Oct-2014

STAFF USE ONLY
Application
Status 
Assessment
Due-Date 
Form ID #
APPROVED

07-May-2015

NA04

Trip Proposal Section

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

1

2) Traveler Contact Information and Itinerary:

TravelerEmailFrom
City
From
Country
Depart
Date
Return
Date
Evan Leibovitchevan@telly.orgTorontoCanada11-Apr-201515-Apr-2015
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
4) Event/Conference Name, Title, or Descriptor:ARIN 35
5) Event/Conference Dates:
Start:12-Apr-2015End:15-Apr-2015
6) Event/Conference Website Link:https://www.arin.net/participate/meetings/index.html
7) Primary Event/Conference Location:
Street
Address:
JW Marriott San Francisco Union Square 515 Mason Street San Francisco California 94102 USA
City:San FranciscoCountry:USA
8) ICANN Geographic Region:North America

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


American Registry for Internet Numbers

 

10) Purpose and Goals:

1) To further enhance relationship between NARALO and ARIN 2) To engage with ARIN members to identify issues of importance to the At-Large Community 3) To increase awareness of At-Large and NARALO issues within ARIN

11) Proposed Outcomes:Completion of an MoU between NARALO and ARIN New ALS applications from civil society members of ARIN New policy initiatives for NARALO
12) Additional Information (optional):

Community 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.YesAllan Skuce12-Jan-2015Participant is familiar with the program operations and term&Conditions.
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.YesAllan Skuce12-Jan-2015Executive of NARALO authorizes this proposal and approval of the CROPP RT has been given.
The ICANN Stakeholder Engagement Vice-President has concurred that the Purpose/Goals of this Trip Proposal are consistent with operational plans and/or strategies.YesAllan Skuce12-Jan-2015Approval has been given.
  =======================================================

 


 

Program Administration: STAFF USE ONLY
Program RequirementDate Satisfied/ConfirmedInitialsNotes
Constituency Travel Notified12-Jan-2015JDLJoseph acknowledged and has begun communications
Trip Proposal Approved and
Transferred to Official Forms: 
Trip Assessment Approved and
Transferred to Official Forms: 


CROPP Application Template v8 (May 2014)

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