Trip Proposal Section |
1) Number of Travelers:
(Note: each traveler uses one trip of the five (5) allocated to each organization/structure). | | Number data |
|---|
| minValue | 1 |
|---|
| maxValue | 5 |
|---|
| name | TRIPS |
|---|
| format | ### |
|---|
| required | true |
|---|
|
|
| Table data |
|---|
| name | TRAVELERS |
|---|
| initialRows | 1 |
|---|
| | Traveler | Email (Redacted) | Alternate | Email (Redacted) |
|---|
| Text data |
|---|
| name | TRAVELER |
|---|
| type | line |
|---|
| required | true |
|---|
|
| | | |
|
|
| 2) Application Date: | | Date data |
|---|
| name | APPDATE |
|---|
| format | dd-MMM-yyyy |
|---|
|
|
3) Dates of Requested Travel: | | Departure: | | Date data |
|---|
| name | DEPART |
|---|
| format | dd-MMM-yyyy |
|---|
| required | true |
|---|
|
| | Return: | | Date data |
|---|
| name | RETURN |
|---|
| format | dd-MMM-yyyy |
|---|
| required | true |
|---|
|
|
|
4) Travel Itinerary:
| | From City: | | Country: | | | To City: | | Country: | | Other:
(Describe) | |
|
| 5) Event/Conference Name, Title, or Descriptor: | |
| 5a) Event/Conference Website Link: | |
| 6) Primary Event/Conference Location: | |
| 7) ICANN Geographic Region: | | List data |
|---|
| | List option |
|---|
| sortValue | C |
|---|
| value | Australasia/Pacific Islands |
|---|
|
| List option |
|---|
| sortValue | E |
|---|
| value | Latin America and Caribbean |
|---|
|
| List option |
|---|
| sortValue | F |
|---|
| value | Middle East |
|---|
|
| List option |
|---|
| sortValue | G |
|---|
| value | North America |
|---|
|
| List option |
|---|
| sortValue | H |
|---|
| value | Russia/CIS/Eastern Europe |
|---|
|
|
|
8) Activity Sponsors:
(Note: all event sponsors must be identified in order to comply with ICANN travel guidelines).
| |
9) Purpose and Goals: | |
| 10) Proposed Outcomes: | |
| 11) Additional Information (optional): | |
ACKNOWLEDGEMENTS (Required): |
The participants identified in this application are familiar with the Program Operations associated with this Community Regional Outreach Pilot Program (FY14) 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. | |
Trip Assessment Section |
1) Describe how the original Purpose and Goals were accomplished: | |
2) Describe how the original Outcomes were achieved: | |
| 3) Date Completed: | | Date data |
|---|
| name | COMPLETED |
|---|
| format | dd-MMM-yyyy |
|---|
|
|
| 4) Additional information pertaining to this outreach event (optional): | |
| | ============================================= |