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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 Program Coordinator (PC) 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: CROP Staff.

Person Completing Form
Name:


Maryam Bakoshi

Date:


10-May-2018

STAFF USE ONLY
Application
Status 
Assessment
Due-Date 


20-Jul-2018

Trip Proposal Section

LINK TO TRIP ASSESSMENT : NPOC Trip Assessment 4 DRAFT

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

1

2) Traveler Contact Information and Itinerary:

TravelerEmailFrom
City
From
Country
Depart
Date
Return
Date
EMERSON DURAN RODRIGUEZdireccion@orinocotic.org 25-Jun-201828-Jun-2018
3) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
4) Event/Conference Name, Title, or Descriptor:ICANN62 Panama
5) Event/Conference Dates:
Start:25-Jun-2018End:28-Jun-2018
6) Event/Conference Website Link:https://meetings.icann.org/en/panamacity62
7) Primary Event/Conference Location:
Street
Address:
Megapolis Convention Center Boulevard El Hayek
City:Panama CityCountry:Panama

8) Indicate whether it is a regional trip OR an out-of-region trip.


Regional
9) ICANN Global Stakeholder Engagement Region:Latin America and Caribbean

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


11) Proposed Goals and Outcomes:

Content Guidelines (click here)

As an IT cluster board director and clúster manager I will be attending the Panama meeting in order to learn more about ICANN, Policy Development and how I can assist NPOC in writing policy statements, encourage LAC Region to become more engaged and collaborate with NCSG and the GNSO.
12) Additional Information (optional):


_______________________________________________________________ 
Acknowledgements Section

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

AcknowledgementsConfirmed?NameDateNotes
The participants identified in this application agree to abide by the terms and conditions of this FY18 Community Regional Outreach Program (CROP) as outlined on the CROP Procedures & Guidelines page. YesMaryam Bakoshi10-May-2018
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.YesMaryam Bakoshi10-May-2018
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 CROP Staff Administrators confirm that this trip 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 Assessment


CROP Trip Proposal Template (May 2017)

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