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: | Tijani BEN JEMAA | Date: | 11-Jun-2014 |
|---|
| Application Status | Assessment Due-Date | Form ID # |
| DISAPPROVED | 07-Aug-2014 | AF01 |
Trip Proposal Section | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1) Number of Travelers: | 1 | ||||||||||||
2) Traveler Contact Information and Itinerary:
| |||||||||||||
| 3) Special Travel Circumstances, Arrangements, Explanations, or Notations: (Please identify each traveler, as applicable) | Visa is required and costs 50 000.00 Francs CFA (about 80 €) | ||||||||||||
| 4) Event/Conference Name, Title, or Descriptor: | First Internet Governance Forum in Gabon | ||||||||||||
| 5) Event/Conference Dates: |
| ||||||||||||
| 6) Event/Conference Website Link: | Not yet available | ||||||||||||
| 7) Primary Event/Conference Location: |
| ||||||||||||
| 8) ICANN Geographic Region: | Africa | ||||||||||||
9) Activity Sponsors: |
| ||||||||||||
10) Purpose and Goals: | We have to work on Internet governance and ICANN strategy for Africa. We will raise the Gabonese structures on the role they can play in the Central Africa sub-region. | ||||||||||||
| 11) Proposed Outcomes: | • Educate twenty (20) Gabonese structures operating AFRALO • Recruit at least three (03) Gabonese structures for new African ALS • Perform (01) comparative study between the national IGF Senegal and the national IGF Gabon (a sub item will address the role of young people in this hitch). | ||||||||||||
| 12) Additional Information (optional): | National IGF Gabon; the days selected are 14, 15 and 16 July 2014 | ||||||||||||
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 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. | Yes | Tijani BEN JEMAA | 11-Jun-2014 | |
| The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal. | Yes | Aziz Hilali | 11-Jun-2014 | |
| The ICANN Stakeholder Engagement Vice-President has concurred that the Purpose/Goals of this Trip Proposal are consistent with operational plans and/or strategies. | Yes | Pierre Dandjinou | 11-Jun-2014 | |
| =============== | ========== | ============================== |
| Program Requirement | Date Satisfied/Confirmed | Initials | Notes |
| Constituency Travel Notified | 12-Jun-2014 | JDL | 12 Jun: Not in the 6 week window, but have sent request to ICANN Travel 14 Jun: ICANN Travel unable to process request due to advanced notice less than 6 weeks |
| Trip Assessment Approved and Transferred to Official Forms: |
|---|
CROPP Application Template v8 (May 2014)
