Section |
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Column |
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| Info |
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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. |
Note |
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Trip Proposals must be completed at least six (6) weeks before the event start date. |
Person Completing Form: | Text data |
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name | PERSON |
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type | line |
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content | text |
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required | true |
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| Date: | Date data |
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name | APPDATE |
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format | dd-MMM-yyyy |
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name | APPDATE |
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required | true |
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Column |
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| Panel |
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bgColor | white |
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titleColor | maroon |
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titleBGColor | lightcyan |
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title | STAFF USE ONLY |
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| Application Status | Assessment Due-Date | Form ID # | | | |
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Trip Proposal Section |
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1) Number of Travelers: (Note: Each traveler uses one trip of the five (5) allocated to each organization/structure). | Number data |
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minValue | 1 |
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maxValue | 5 |
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formatwidth | ###100px |
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name | TRIPS |
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widthformat | 100px### |
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2) Traveler Contact Information and Itinerary: Table data |
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name | CONTACTINFO |
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initialRows | 1 |
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| Traveler | Email | From City | From Country | Depart Date | Return Date |
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Text data |
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name | TRAVELER1 |
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type | line |
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content | text |
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name | FROM1 |
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type | line |
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content | text |
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| Text data |
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name | FROM2 |
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type | line |
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content | text |
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| Date data |
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name | DEPART |
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format | dd-MMM-yyyy | name | DEPART |
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| Date data |
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name | RETURN |
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format | dd-MMM-yyyy |
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name | RETURN |
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3) Special Travel Circumstances, Arrangements, Explanations, or Notations: (Please identify each traveler, as applicable) | Text data |
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width | 650px |
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name | SPECIAL | width |
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650px | content | text |
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4) Event/Conference Name, Title, or Descriptor: | |
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5) Event/Conference Dates: | Start: | Date data |
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name | START |
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format | dd-MMM-yyyy | name | START |
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| End: | Date data |
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name | END |
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format | dd-MMM-yyyy |
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name | END |
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6) Event/Conference Website Link: | |
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7) Primary Event/Conference Location: | Street Address: | |
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City: | Text data |
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name | CITY |
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type | line |
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content | text |
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| Country: | Text data |
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name | COUNTRY |
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type | line |
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content | text |
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8) ICANN Geographic Region: | List data |
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| List option |
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sortValue | C |
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value | Australasia/Pacific Islands |
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List option |
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sortValue | E |
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value | Latin America and Caribbean |
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List option |
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sortValue | F |
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value | Middle East |
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List option |
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sortValue | G |
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value | North America |
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List option |
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sortValue | H |
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value | Russia/CIS/Eastern Europe |
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9) Activity Sponsors: (Note: all event sponsors must be identified in order to comply with ICANN travel guidelines).
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10) Purpose and Goals: | |
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11) Proposed Outcomes: | |
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12) Additional Information (optional): | |
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Panel |
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titleColor | navy |
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titleBGColor | lightyellow |
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title | Community Confirmation Section |
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Note: To be completed by a Pilot Program Coordinator (PPC) designated by this organization/structure. Acknowledgements | Confirmed? | Name | Date | Notes |
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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. | | Text data |
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name | ACKNAME-1 |
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type | line |
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content | text |
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| Date data |
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name | ACKDATE-1 |
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format | dd-MMM-yyyy |
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name | ACKDATE-1 |
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| Text data |
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width | 300px |
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name | ACKNOTES-1 | width |
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300px | content | text |
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| The ICANN Organization / Structure's leadership has authorized the submission of this Trip Proposal. | | Text data |
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name | ACKNAME-2 |
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type | line |
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content | text |
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| Date data |
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name | ACKDATE-2 |
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format | dd-MMM-yyyy | name | ACKDATE-2 |
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| Text data |
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width | 300px |
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name | ACKNOTES-2 |
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width | 300px |
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content | text |
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| The ICANN Stakeholder Engagement Vice-President has concurred that the Purpose/Goals of this Trip Proposal are consistent with operational plans and/or strategies. | | Text data |
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name | ACKNAME-3 |
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type | line |
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content | text |
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| Date data |
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name | ACKDATE-3 |
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format | dd-MMM-yyyy | name | ACKDATE-3 |
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| Text data |
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width | 300px |
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name | ACKNOTES-3 | width |
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300px | content | text |
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| | | =============== | ========== | ============================== |
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...
Panel |
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bgColor | lightyellow |
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titleColor | maroon |
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titleBGColor | lightcyan |
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title | Program Administration: STAFF USE ONLY |
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Table data |
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name | REQUIREMENTS |
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initialRows | 1 |
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| Program Requirement | Date Satisfied/Confirmed | Initials | Notes | List data |
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| List option |
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sortValue | A |
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value | Speakers Bureau |
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List option |
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sortValue | B |
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value | Communications Department |
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List option |
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sortValue | C |
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value | Meetings Team |
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List option |
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sortValue | D |
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value | Constituency Travel Notified |
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List option |
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sortValue | E |
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value | Travel Booked |
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List option |
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sortValue | F |
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value | Program Criteria Satisfied |
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| Date data |
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name | SATISFIED |
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format | dd-MMM-yyyy |
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name | SATISFIED |
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| List data |
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width | 50px |
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name | INITIALS | width | 50px |
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| Text data |
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width | 300px |
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name | NOTES |
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width | 300px |
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content | text |
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Trip Proposal Approved and Transferred to Official Forms: | Date data |
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name | P-POSTED |
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format | dd-MMM-yyyy | name | P-POSTED |
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| Trip Assessment Approved and Transferred to Official Forms: | Date data |
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name | A-POSTED |
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format | dd-MMM-yyyy | name | A-POSTED |
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CROPP Application Template v8 (May 2014)