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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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Outreach/Engagement Event Proposals must be completed at least eight (8) weeks before the event start date. |
Person Completing Form |
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Name: | 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 Submitted: | 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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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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| Event Status | Assessment Due-Date | Form ID # | | | |
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Event Proposal Section |
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1) Which GNSO structure is submitting this request: | |
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2) Who will be the principal liaison assigned to work with Communications: | Name: | Text data |
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name | LIAISON |
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width | 650px |
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name | LIAISON |
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type | line |
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content | text |
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| Email: | Text data | width |
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650px | name | L-EMAIL |
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width | 650px |
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type | line |
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content | text |
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3) Event Title or Descriptor: | |
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4) Preferred Event Dates: (Note: Due to the extensive Staff support and logistical planning associated with events, advanced scheduling and reservations may be required to ensure that (a) only one such event occurs at the same time, and (b) there are no overlaps with other scheduled events such as ICANN Public Meetings). | Start: | Date data |
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name | START |
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format | dd-MMM-yyyy |
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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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5) 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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6) 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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7) Proposed Goals and Outcomes for this Event: (Note: Please address linkages to the Outreach Strategic Plan). | |
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8) 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 Engagement Event goals, dates, and other requirements have been negotiated with applicable ICANN Staff departments and approved as documented above. | | 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 | name |
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ACKDATE-1 | format | dd-MMM-yyyy |
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name | ACKDATE-1 |
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| Text data | width |
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300px | name | ACKNOTES-1 |
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width | 300px |
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content | text |
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| The ICANN Organization / Structure's leadership has authorized the submission of this Engagement Event 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 |
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name | ACKDATE-2 |
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| Text data | width |
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300px | 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 Goals/Outcomes of this Engagement Event 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 |
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name | ACKDATE-3 |
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| Text data | width |
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300px | name | ACKNOTES-3 |
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width | 300px |
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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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name | INITIALS |
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width | 50px | name | INITIALS |
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| Text data |
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name | NOTES |
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width | 300px |
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name | NOTES |
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content | text |
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Event Proposal Confirmed and Transferred to Approved Forms: | Date data |
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name | P-POSTED |
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format | dd-MMM-yyyy |
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name | P-POSTED |
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| Event Assessment Confirmed and Transferred to Approved Forms: | Date data |
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name | A-POSTED |
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format | dd-MMM-yyyy |
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name | A-POSTED |
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CROPP Outreach Engagement Event Template v2 (May 2015)