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:Alberto SotoDate:

15-Apr-2015

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WITHDRAWN

05-Jul-2015

LAC05

Trip Proposal Section

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

2

2) Traveler Contact Information and Itinerary:

TravelerEmailFrom
City
From
Country
Depart
Date
Return
Date
Eduardo José Méndez Gil Medellín Colombia11-Jun-201514-Jun-2015
Sergio Walter Salinas Porto Mar del PlataArgentina11-Jun-201514-Jun-2015
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
None
4) Event/Conference Name, Title, or Descriptor:Internet Governance meeting
5) Event/Conference Dates:
Start:12-Jun-2015End:13-Jun-2015
6) Event/Conference Website Link: http://www.gobernanza-internet.org.ni   ( website under construction)
7) Primary Event/Conference Location:
Street
Address:
Auditorio Salomón de la Selva - Universidad Nacional de Ingeniería Avenida Universitaria Managua, Apartado Postal: 5595
City:ManaguaCountry:Nicaragua
8) ICANN Geographic Region:Latin America and Caribbean

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


NIC.NI, CONICYT, ISIC, Monchito

10) Purpose and Goals:

Meeting the civil society, the industry and government to participate in the discussion about internet Governance under the definition of multistakeholder and promote the foundation of new ALSs.

11) Proposed Outcomes:• Introduce the civilsociety on the importance of internet Gobernance. • Join responsibility withorder to propose defined goals towards a more participative Internet. • the civil society, the industry and government to participate in the discussion about internet Governance under the definition of multistakeholder . promote the foundation of new ALSs.
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.
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.
The ICANN Stakeholder Engagement Vice-President has concurred that the Purpose/Goals of this Trip Proposal are consistent with operational plans and/or strategies.
  =======================================================

 


 

Program Administration: STAFF USE ONLY
Program RequirementDate Satisfied/ConfirmedInitialsNotes
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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