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Instructions:

1. You must be logged in to the Community Wiki with a valid Username and Password in order to complete forms within CROP.

2. Your organization must first complete and get approval for the Outreach Strategic Plan before any CROP trip could be processed.  

3. There are two CROP forms required for each Trip: a) a Trip Proposal; b) a Trip Assessment (must be complete within three (3) weeks of all travelers having returned from the event, no later than the assessment due date which is automatically calculated based on the trip return date).

4. Multiple travelers are asked to collaborate as a team in pulling together the appropriate information.

5. To fill out the the form, click  (top of the screen)

6. Answer each of the questions that appears within the form. Use the scroll bar (right) to reveal all contents. Click here to read the full instructions

IMPORTANT: This form must be completed by the traveler him/herself.

Person Completing Form
Name:

Khalid Samara

Date:

10-Nov-2018

STAFF USE ONLY

Application
Status 

IN PROGRESS

TRAVELER DEADLINE

Assessment Due Date

05-Apr-2019

Link to Trip Assessment

ISPC Trip Assessment 1

Trip Proposal Section

1) Traveler Contact Information and Itinerary:

TravelerEmailFrom
City		From
Country		Depart DateReturn Date
Khalid samara
               khalidsamara10@gmail.com
Amman
Jordan
11-Mar-2019
14-Mar-2019
2) Special Travel Circumstances, Arrangements,
Explanations, or Notations: 
(Please identify each traveler, as applicable)
3) Event/Conference Name, Title, or Descriptor:
ICANN64 Kobe
4) Event/Conference Dates:
Start:
09-Mar-2019
End:
14-Mar-2019
5) Event/Conference Website Link:
             https://meetings.icann.org/en/kobe64
6) Primary Event/Conference Location:
Street
Address:
Kobe Portopia Hotel & Kobe International Conference Center
City:
Kobe
Country:
Japan
7) ICANN Global Stakeholder Engagement Region:
Middle East

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


            

- ISPCP meetings
-CSG Open meetings
- ISPCP Outreach event

9) Proposed Goals and Outcomes:

Content Guidelines (click here)



Participation in CROP will allow me to support the ISPCP’s outreach event scheduled for Wednesday, 13 March 2018 in Kobe, Japan. Building on the successful ISPCP event held during ICANN63 Barcelona, the ISPCP is actively working to use the materials from this event to generate interest for a similar, but smaller event in Japan (materials can be seen at https://www.ispcp.info/icann63-ispcp-outreach [ispcp.info]). I will be working with the ISPCP sub-committee and ICANN GSE team and support staff (Jia-Rong Low, Chris Mondini, and Chantelle Doerksen) to assist in the development and planning for the event.


In my personal capacity as the Chair of the Middle East Network Operators Group (MENOG) which cover 15 countries in Middle East, I will be able to bring back any important information and contact details to MENOG members. I believe from an outreach perspective, this is an excellent opportunity for the ISPCP to create synergies between two distinct areas located within ICANN’s AP region for future relationship building and partnership opportunities.

10) Additional Information (optional):

11) Consent & Authorization:

By submitting my personal data, I agree that my personal data will be processed in accordance with the ICANN Privacy Policy, and agree to abide by the website Terms of Service.

If you agree to text above, please fill out your name and date in the box on the right.


NameDate

Khalid Samara

10-Nov-2018

_______________________________________________________________
Acknowledgements Section

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

AcknowledgementsConfirmed?Who Confirmed?Date of ConfirmationNotes
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.
Yes
Chantelle Doerksen
12-Nov-2018
The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal.
Yes
Chantelle Doerksen
12-Nov-2018
On behalf of Wolf-Ulrich Knoben, ISPCP Chair
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/ConfirmedStaff NameNotes


CROP Trip Proposal Template (June 2018)

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