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 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
Name:

Date:

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

IPC01

This particular traveler counts for 2 against the IPC's trip allocation.

Trip Proposal Section

LINK:  FY17 IPC Trip Assessment 1

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

2) Traveler Contact Information and Itinerary:

TravelerEmailFrom
City		From
Country		Depart
Date		Return
Date
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
4) Event/Conference Name, Title, or Descriptor:
5) Event/Conference Dates:
Start:End:
6) Event/Conference Website Link:
7) Primary Event/Conference Location:
Street
Address:
City:Country:
8) ICANN Global Stakeholder Engagement Region:

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


10) Proposed Goals and Outcomes:

Content Guidelines (click here)

 

11) Additional Information (optional):

=============================================================== 
Acknowledgements Section

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

AcknowledgementsConfirmed?NameDateNotes
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.
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 CROPP Staff Administrators confirm that this trip/event satisfies the program's terms, guidelines, and policies.
  =======================================================
Program Administration: STAFF USE ONLY

Approved Travel Elements:

TravelerApproved
Arrival Date		Approved
Departure Date		Approved Fees 

Staff Department Notifications:

Program RequirementDate Satisfied/ConfirmedInitialsNotes

Program Admin Transfers from Community Drafts to Approved Forms:

Trip Proposal Trip/Event Assessment


CROPP-FY17 Trip Proposal Template (Jul 2016)