NCAS-M Travel Request Step 1 of 4 25% Traveler InformationIn this section, provide information about yourself that will be used to make travel arrangements.Traveler's Full Name(Required)Indicate name as it appears on your passport and/or state issued identification card/driver’s license. First Middle Last Traveler's Contact Number(Required)Traveler's Email(Required) Traveler's Gender(Required) Male Female Other Traveler's Date of Birth(Required) MM slash DD slash YYYY Travel DetailsIn this section, provide details regarding the Event, Conference, or Symposium that you are interested in traveling for.Name of Event, Conference, or Symposium(Required) Location of Event, Conference, or Symposium(Required) City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Start Date of Event, Conference, or Symposium(Required) MM slash DD slash YYYY End Date of Event, Conference, or Symposium MM slash DD slash YYYY Upload Registration Receipt (if applicable)You must be registered for the event/conference/symposium before travel arrangements are made for you.Max. file size: 128 MB.Travel Departure Date(Required)Please state the exact date of departure. It should be one day in advance of your required attendance to your conference. MM slash DD slash YYYY What airport will you be leaving from?(Required)List airport code (e.g. IAD) What time of day do you prefer to begin your departure travel?(Required)Select timeMorningAfternoonEveningNo PreferenceTravel Return Date(Required)Please state the exact date of return travel. MM slash DD slash YYYY What airport will you be returning to?(Required)List airport code (e.g. IAD) What time of day do you prefer to begin your return travel?(Required)Select timeMorningAfternoonEveningNo PreferenceWill a hotel be needed?(Required)Note that the hotel for NCAS-M II ACE is the Kellogg Conference Center and Hotel at Gallaudet University. Yes No N/A List three (3) hotel alternatives in the event that conference-contracted hotels are unavailable.Click the plus (+) for additional lines. Add RemoveWill a rental car be needed?This option is for faculty and staff only. Yes No Please write any special needs or accommodations that will be needed for this trip below:(Required)Enter N/A if this is not applicable. NCAS-M II Advisor InformationIdentify your NCAS-M II advisor from the list.(Required)Select advisorDr. Terri Adams (tadams-fuller@howard.edu)Dr. Sen Chiao (sen.chiao@howard.edu)Dr. Belay Demoz (bdemoz@umbc.edu)Dr. Rosa Fitzgerald (rfitzgerald@utep.edu)Dr. Jose Fuentes (juf15@psu.edu)Dr. Thomas Gill (tegill@utep.edu)Dr. Hector Jimenez (hectorj.jimenez@upr.edu)Dr. Haydar Kurban (hkurban@howard.edu)Dr. Xin-Zhong Liang (xliang@umd.edu)Dr. Duanjuan Lu (duanjun.lu@jsums.edu)Dr. Remata Reddy (remata.s.reddy@jsums.edu)Dr. Ricardo Sakai (ricardo.k.sakai@howard.edu)Dr. Sonya Smith (ssmith@howard.edu)Dr. William Stockwell (william.r.stockwell@gmail.com)Dr. Qian Tan (qian.tan@sjsu.edu)Dr. Christopher Thorncroft (cthorncroft@albany.edu)Dr. Tia Tyree (ttyree@howard.edu)Dr. Loren White (loren.d.white@jsums.edu)N/A – I am a faculty/staff memberAdvisor Email(Required)This is required to route the travel request to your NCAS-M advisor for approval before travel arrangements are made. Enter Email Confirm Email Signature(Required)Signature Date(Required) MM slash DD slash YYYY For any questions, please contact Kimberly Smith, NCAS-M Assistant Director, at 202.865.8536 or kl_smith@howard.edu
