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 | |||
|---|---|---|---|
| Name: | Glenn McKnight | Date: | 01-Mar-2016 |
| Application Status | Assessment Due-Date | Form ID # |
| PENDING | 02-Jul-2016 | NA07 |
Trip Proposal Section | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
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) | No special requirements | ||||||||||||
| 4) Event/Conference Name, Title, or Descriptor: | 2016 National League of Cities Cities Summit (formerly Congress of Cities) Pittsburgh, PA November 16-19, 2016 | ||||||||||||
| 5) Event/Conference Dates: |
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| 6) Event/Conference Website Link: | https://personaldemocracy.com/product/personal-democracy-forum-2016-registration | ||||||||||||
| 7) Primary Event/Conference Location: |
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| 8) ICANN Geographic Region: | North America | ||||||||||||
9) Activity Sponsors: | The event is sponsored by Microsoft. It's parent organization is sponsored by Microsoft, Google, and the Omidyar Network. | ||||||||||||
10) Proposed Goals and Outcomes: | The primary goals/outcomes of attending this conference are twofold: first to raise awareness of NARALO and ICANN in the context of the personal democracy movement which is at it's heart dependent upon the Internet; and second to return back to NARALO inputs from users outside the organization to enrich our insights and enable us to make better policy contributions within the Internet governance ecosystem. | ||||||||||||
| 11) Additional Information (optional): | |||||||||||||
| ======================================= | |||||||||||||
Note: To be completed by a Pilot Program Coordinator (PPC) designated by this organization/structure.
| Acknowledgements | Confirmed? | Name | Date | Notes |
|---|---|---|---|---|
| The participants identified in this application agree to abide by the terms and conditions of this FY16 Community Regional Outreach Pilot Program (CROPP) as outlined on the Program Elements 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. | ||||
| =============== | ========== | ============================== |
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 |
| Trip Proposal Confirmed and Transferred to Approved Forms: | Trip/Event Assessment Confirmed and Transferred to Approved Forms: |
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CROPP Trip Proposal Template v4 (Aug 2015)
