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 | |||
|---|---|---|---|
| Name: |
| Date: |
|
| Application Status | Assessment Due-Date | Form ID # |
|
| AF07 |
Trip Proposal Section | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1) Number of Travelers: | |||||||||||||
2) Traveler Contact Information and Itinerary:
| |||||||||||||
| 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: |
| ||||||||||||
| 6) Event/Conference Website Link: | |||||||||||||
| 7) Primary Event/Conference Location: |
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| 8) ICANN Global Stakeholder Engagement Region: | |||||||||||||
9) Activity Sponsors: | |||||||||||||
10) Proposed Goals and Outcomes: Content Guidelines (click here)
| |||||||||||||
| 11) Additional Information (optional): | |||||||||||||
| =============================================================== | |||||||||||||
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 |
|---|---|---|---|---|
| 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. | ||||
| =============== | ========== | ============================== |
Approved Travel Elements:
| Traveler | Approved Arrival Date | Approved Departure Date | Approved Fees |
|---|---|---|---|
|
Staff Department Notifications:
| Program Requirement | Date Satisfied/Confirmed | Initials | Notes |
Program Admin Transfers from Community Drafts to Approved Forms: | |||
|---|---|---|---|
| Trip Proposal | Trip/Event Assessment | ||
CROPP-FY17 Trip Proposal Template (Jul 2016)