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: | Arce José Francisco | Date: | 08-May-2015 |
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| Application Status | Assessment Due-Date | Form ID # |
| WITHDRAWN | 16-Jun-2015 | LAC09 |
Trip Proposal Section | |||||||||||||
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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) | |||||||||||||
| 4) Event/Conference Name, Title, or Descriptor: | ICANN 53 | ||||||||||||
| 5) Event/Conference Dates: |
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| 6) Event/Conference Website Link: | https://buenosaires53.icann.org/en/ | ||||||||||||
| 7) Primary Event/Conference Location: |
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| 8) ICANN Geographic Region: | Latin America and Caribbean | ||||||||||||
9) Activity Sponsors: | CROPP Program | ||||||||||||
10) Purpose and Goals: | 1.- Be volunteerto at the ICANN’s Newcomer’s booth 2.- Join a minimum of one At-Large Working Group (WG) 3.- Be mentor for less engaged LACRALO members present at the meeting 4.- Explore opportunities in all At-large activities to increase the participating in our Region 5.- Collaborate with all activities in the region, such as LACRALO showcase, and any activity that Chair or Secretary needs. 6.- Collaborate with activities related to ICANN's strategy in the region 7.- Collaborate assembling documents to be presented at meetings on different issues. 8.- And any other that may arise from the region´s needs | ||||||||||||
| 11) Proposed Outcomes: | Trip report | ||||||||||||
| 12) 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 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. | ||||
| The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal. | ||||
| The ICANN Stakeholder Engagement Vice-President has concurred that the Purpose/Goals of this Trip Proposal are consistent with operational plans and/or strategies. | ||||
| =============== | ========== | ============================== |
| Program Requirement | Date Satisfied/Confirmed | Initials | Notes |
| Trip Proposal Approved and Transferred to Official Forms: | Trip Assessment Approved and Transferred to Official Forms: |
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CROPP Application Template v8 (May 2014)
