STScI Logo

Staff Research
Visitor Information Form - Part A

This form should be filled out by the STScI staff member requesting visitor support at least six weeks in advance of the planned visit. Do not use this form for Caroline Herschel program visitors, use the Caroline Herschel Visitor Information Form instead.

When you are finished entering information click the "SUBMIT" button at the bottom of the page. Upon approval, your visitor will be sent information about how to fill in Part B, with more detailed information about travel, accommodations, etc.

* indicates a required field

* STScI Host's Name:
* STScI Host's Email:
* Visitor's Name:
* Visitor's E-mail:
* Visitor's Home Institution:
* Visitor's Nationality:
   For non-US citizens,
   does the speaker have a green card?
Yes     No 
* Visitor's Telephone Number:
* Emergency Contact Name:
* Emergency Contact Phone Number:
* Relationship of Emergency Contact to Visitor:
Do you need an office for this visitor?
(We will make an attempt to accommodate your request)
Yes     No 
If yes, which building:
Do you need an access card for this visitor?
(Must return access card to front desk after visit)
Yes     No 
Visitor Type:
Anticipated Date of Arrival to STScI:
Anticipated Date of Departure from STScI:
Hotel Needed Yes     No 
Estimated Expenses:
Travel:   Lodging:    Per Diem:    Other:

* Justification: Please briefly describe the nature of the visit, planned activities, and expected outcome.

Other Comments and Information:

Source of Funding:

Requesting support from the DDRF Visitor Program? Yes No

Providing support from a grant or other DDRF account? Yes No

If yes, enter account number.
Account #: