Instructions:
- Please use the <Edit Contents> menu option (directly above) to complete this form. Remember to <Save> the page (bottom right) after making updates.
- Multiple travelers are asked to collaborate as a team in pulling together the appropriate information.
- 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.
- This form may be edited/saved as many times as needed. When completed, please notify your Pilot Program Coordinator (PPC) for further processing.
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: CROPP Staff.
Person Completing Form | |||
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Name: | Maryam Bakoshi | Date: | 28-Apr-2017 |
Application Status | Assessment Due-Date | Form ID # |
| 21-Jul-2017 | NPOC03 |
Trip Proposal Section | |||||||||||||
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1) Number of Travelers: | 1 | ||||||||||||
2) Traveler Contact Information and Itinerary:
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3) Special Travel Circumstances, Arrangements, Explanations, or Notations: (Please identify each traveler, as applicable) | 4th Night would be funded by the traveller | ||||||||||||
4) Event/Conference Name, Title, or Descriptor: | ICANN 59 Johannesburg | ||||||||||||
5) Event/Conference Dates: |
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6) Event/Conference Website Link: | https://meetings.icann.org/en/johannesburg59 | ||||||||||||
7) Primary Event/Conference Location: |
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8) ICANN Global Stakeholder Engagement Region: | Africa | ||||||||||||
9) Activity Sponsors: | |||||||||||||
10) Proposed Goals and Outcomes: Content Guidelines (click here)
| NPOC will benefit from my participation through a focused and dedicated contribution at any NPOC precise events and generic ICANN activities deemed beneficial to the non-profit concern constituency and particularly worthy of adding value to our civil society organizations like the African Civil Society on the Information Society (ACSIS) where I am currently the Vice President and the Nigeria DigitalSENSE Forum series on Internet Governance for Development (IG4D) and related events. I also intend to write a blog post on the outcome of ICANN59 as part of knowledge sharing and continuous development. These, I earnestly think will encourage new membership for NPOC, mostly from Africa. | ||||||||||||
11) Additional Information (optional): | |||||||||||||
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Note: The first three elements below should be completed by a Pilot Program Coordinator (PPC) designated by this organization/structure.
Acknowledgements | Confirmed? | Name | Date | Notes |
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The participants identified in this application agree to abide by the terms and conditions of this FY17 Community Regional Outreach Pilot Program (CROPP) as outlined on the CROPP Procedures & Guidelines page. | Yes | Maryam Bakoshi | 28-Apr-2017 | |
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal. | Yes | Maryam Bakoshi | 28-Apr-2017 | |
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 CROPP Staff Administrators confirm that this trip/event satisfies the program's terms, guidelines, and policies. | ||||
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Approved Travel Elements:
Traveler | Approved Arrival Date | Approved Departure Date | Approved Fees |
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Staff Department Notifications:
Program Requirement | Date Satisfied/Confirmed | Initials | Notes |
Program Admin Transfers from Community Drafts to Approved Forms: | |||
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Trip Proposal | Trip/Event Assessment |
CROPP-FY17 Trip Proposal Template (Jul 2016)