ASTRA Public Form text

Select Request Type Interface

Question: Please Select the Type of Appearance You’re Requesting

Note: The type of appearance you’re requesting will help us gather the correct information to best service your request

Selection: Virtual

Note: An appearance conducted virtually through the internet, video, or phone

Selection: In Person

Note: An appearance at a specific location inside or outside the United States

Acknowledgement: I understand I will e responsible for all expenses incurred to support this appearance (e.g., travel, accommodations, etc.)

Selection: Recorded Greeting

Note: A pre-recorded audio or video greeting/segment delivered to your organization

Request Form Interface

Question: Please Tell Us About Yourself

Note: We need to know who is making the request and who is sponsoring the appearance. Please fill out all the contact information below. AO to provide definitions of the requestor/sponsor for clarification to the user.

Section: Requestor Information

Field: Salutation

Field: First Name

Field: Last Name

Field: Middle Initial

Field: Title

Field: Organization

Field: Email Address

Field: Work Phone

Field: Cell Phone

Field: Home Phone

Field: Address 1

Field: Address 2

Field: City

Field: Country

Field: Postal ZIP Code

Section: Contact Information

Field: Salutation

Field: First Name

Field: Last Name

Field: Middle Initial

Field: Title

Field: Organization

Field: Email Address

Field: Work Phone

Field: Cell Phone

Field: Home Phone

Field: Address 1

Field: Address 2

Field: City

Field: Country

Field: Postal ZIP Code

Section: Sponsor Information

Field: Salutation

Field: First Name

Field: Last Name

Field: Middle Initial

Field: Title

Field: Organization

Field: Email Address

Field: Work Phone

Field: Cell Phone

Field: Home Phone

Field: Address 1

Field: Address 2

Field: City

Field: Country

Field: Postal ZIP Code

Section: Appearance Information

Question: Please tell us about the details for the appearance you are requesting. The more specific the information you can provide us, the better we can process your request.

Field: Title for Appearance

Note: Type a short title for this appearance. We’ll reference this title in any future correspondence.

Field: Start Date

Field: End Date

Field: Drop Dead Date

Field: Are your dates tentative?

Field: Comments about the event

Note: Please enter any comments you feel are useful for us to know about the event and/or your needs.

Field: City

Field: Country

Field: Postal ZIP Code

Section: Topic And Audience

Question: Tell us about any special topics you would like the speaker to discuss, as well as the type of audience and audience size.

Field: Topic(s) Requested

Note: Enter any special topics you would like discussed. This helps our astronauts prepare for your event

Field: Target Audience

Note: Example: Engineers, Academia, Medical School aged, etc…

Field: Audience Size

Note: Approximate number of audience members

Field: Organization Type

Field: Web Site

Note: URL of your organization’s website

Field: Fundraising (Boolean yes/no)

Field: Fundraising Comments

Section: Astronaut(s) Requested

Description: Indicate how many astronauts you are requesting, any specific astronaut(s) you would like to request, and any background traits you feel will make the appearance successful. Please note that due to scheduling and mission constraints any specific astronaut you request may be unavailable. Also note that only active NASA astronauts are available for named astronaut selection.

Field: Number of Astronauts Requested

Selection: I’ll take any astronaut

Selection: I’d like to request a specific astronaut(s)

Selection: I’d like to request a specific astronaut(s) but will take any if unavailable

Field: Astronaut has flown missions (Boolean yes/no)

Field: Military Branch Background