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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:Yolande JimenezDate:

13-May-2015

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

03-Jul-2015

BC02

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
Waudo Sigangaemailsignet@mailcan.comNairobiKenya09-Jun-201513-Jun-2015
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
4) Event/Conference Name, Title, or Descriptor:AfICTA Roundtable meeting
5) Event/Conference Dates:
Start:10-Jun-2015End:11-Jun-2015
6) Event/Conference Website Link:http://www.aficta.org/roundtable/
7) Primary Event/Conference Location:
Street
Address:
Transcorp Hilton Abuja, 1 Aguiyi Ironsi St, Maitama
City:AbujaCountry:Nigeria
8) ICANN Geographic Region:Africa

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


Dr Waudo Siganga would work with Andrew Mack to talk about ICANN unique structure and the BC in particular.

10) Purpose and Goals:

The meeting targets select CEOs and other senior decision-makers in Nigeria and it is an ideal opportunity to spread information on the benefits of engaging with ICANN and the ICANN Business Constituency.

11) Proposed Outcomes:Outreach for ICANN Business Constituency for awareness and diversification of membership as a way of addressing volunteer burn-out.
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.YesYJ14-May-2015Email from travellers and BC Outreach team confirms knowledge and understanding
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.YesYJ14-May-2015Email from BC Chair and Outreach committee
The ICANN Stakeholder Engagement Vice-President has concurred that the Purpose/Goals of this Trip Proposal are consistent with operational plans and/or strategies.YesYJ08-May-2015Email from Pierre and Chris
  =======================================================

 


 

Program Administration: STAFF USE ONLY
Program RequirementDate Satisfied/ConfirmedInitialsNotes
Trip Proposal Approved and
Transferred to Official Forms: 
14-May-2015Trip Assessment Approved and
Transferred to Official Forms: 


CROPP Application Template v8 (May 2014)

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