Trip Proposal Section |
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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| name | TRIPS |
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| format | ### |
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| required | true |
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| Table data |
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| name | TRAVELERS |
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| initialRows | 1 |
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| | Traveler | Email (Redacted) | Alternate | Email (Redacted) |
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| Text data |
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| name | TRAVELER |
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| type | line |
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| required | true |
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| | Text data |
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| name | T-EMAIL |
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| type | line |
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| required | true |
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| | | |
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| 2) Application Date: | | Date data |
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| name | APPDATE |
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| format | dd-MMM-yyyy |
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3) Dates of Requested Travel: | | Departure: | | Date data |
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| name | DEPART |
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| format | dd-MMM-yyyy |
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| required | true |
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| | Return: | | Date data |
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| name | RETURN |
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| format | dd-MMM-yyyy |
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| required | true |
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4) Travel Itinerary:
| | From City: | | Country: | | | To City: | | Country: | | Other:
(Describe) | |
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| 5) Event/Conference Name, Title, or Descriptor: | |
| 5a) Event/Conference Website Link: | |
| 6) Primary Event/Conference Location: | |
| 7) 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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8) Activity Sponsors:
(Note: all event sponsors must be identified in order to comply with ICANN travel guidelines).
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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 |
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| name | COMPLETED |
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| format | dd-MMM-yyyy |
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| 4) Additional information pertaining to this outreach event (optional): | |
| | ============================================= |