LIGO Visitor Appointment Application Form       

Applicants for Visitor Appointments and Site Non-Resident Appointments to Caltech, MIT, and the LIGO Observatories in Hanford or Livingston must complete this form. This information is also required to begin the application process for a Caltech sponsored Visa for applicants who are Foreign Nationals.

All applicants must establish an internal point of contact with a LIGO staff sponsor before submitting a request!

Full Name:
 Surname:                 First Name:               M.I.:


Home Address:
(Include Street, City, State/Province/ZipCode, and Country)


Work Address:
(Include Department, Mailcode, Street, City, State/Province/ZipCode, and Country)


Work Phone:      Work Fax:

Home Phone: Email Address:

Current Position/Title:       
Date Current Position Assumed:

PhD Advisor Home Institution: 
Advisor Email:                

Education Summary:
 Degree                    Field                 Year Awarded   Insititution



Date of Birth:
Place of Birth:
 City                      State/Province           Zip Code        Country


Country of Citizenship:

Visa Status:
 Type of Visa                   Expiration Date
     

Health Insurance Coverage: 

Main site that you wish to visit: Caltech LHO LLO MIT Other:

Other requested site visits:    Caltech  LHO  LLO MIT Other:

Proposed length of visit:  
Proposed start date and end date for visit:
 (MM/DD/YYYY)      (MM/DD/YYYY)
 - 

Are you requesting any monetary reimbursements?Yes No
If "Yes", list what type and how much:
(Examples: airline, hotel, per diem)


Special Reimbursement Needs/Requests:


Laboratory Sponsor:
If you do not have a LIGO Laboratory sponsor, please contact
Norna Robertson (CIT), Mike Landry (LHO), Peter Fritschel (LLO),
or David Shoemaker (MIT) to establish one, prior to submitting
this form.

Justification (short paragraph) for requested visit:

Clicking on the Submit Form button will cause this form to be processed. A pdf copy of the form will be returned to your browser, another will be emailed to you, and a third will be submitted to LIGO.

Please be certain that you have filled out the form completely before you click! Incomplete forms will lead to delays in the discussion of your application.

In addition to submitting the application form electronically, please email to the address below a copy of your CV and Publication List (with refereed publications clearly marked with an ✱ next to them), noting in the email that you are sending these with reference to your visitor application.

Your email should be sent to

Nately Sych

Email: visitorprogram@ligo.caltech.edu

Visitor Appointment Form 07-25-2019