NDU Foreign Delegation Visit Request Form

OMB CONTROL NUMBER: 0704-XXXX
OMB EXPIRATION DATE: XX/XX/XXXX

AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-XXXX, is estimated to
average 30 minutes per response, including the time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information. Send comments regarding the burden estimate or burden reduction
suggestions to the Department of Defense, Washington Headquarters Services, at whs.mcalex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that
notwithstanding any other provision of law, no person shall be subject to any penalty for failing
to comply with a collection of information if it does not display a currently valid OMB control
number.

PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. 2165, National Defense University; 10 U.S.C. 2163 Degree Granting
Authority for National Defense University and E.O. 9397, as amended (SSN).
PURPOSE: The data provided will be used to update your National Defense University (NDU)
record. NDU data are used to authenticate and identify NDU personnel and students; track
academic enrollment, assignments, progress, and assessments; track personnel records and
actions; create academic transcripts and related reports; facilitate award of degrees and
credentials; conduct analysis for regional and DoD academic accreditations; and create reports for
University leadership to aid in the development of effective curricula, facilitate academic
completion requirements.
ROUTINE USES: Data are shared with other Federal/State agencies and contractors for the
purpose of communicating educational credentials and accrediting University programs. For a
complete list of routine uses and authorities see the applicable system of records notice, National
Defense University (NDU) Student Data Files (September 21, 2010, 75 FR 57458). The notice
is located at:
https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570570/
dndu01/
DISCLOSURE: Voluntary. However, if data in NDU systems are not up-to-date, your NDU
entitlements/privileges and the ability of NDU systems to identify you as an NDU-affiliated
person could be delayed or inaccurate. The production of accurate academic transcripts may not
be possible. Home addresses will be used for mustering in the event of an officially declared
manmade or natural disaster (DoDI 3001.02) and for notification of a Privacy compromise, loss
or stolen (breached) personally identifiable information
(PII). If addresses are not correct these two requirements will not be performed with accuracy as
to your location.

NATIONAL DEFENSE UNIVERSITY Foreign Delegation Visit Request Form

Thank you for your interest in visiting NDU. Please examine the following timeline for
requesting a visit to NDU:
-4 weeks prior to your requested visit date: Submit a Foreign Visitor Request to the DIA AND notify
NDU POC (see contact information below) of the intent to visit.
-2 weeks prior to your requested visit date: Fill out NDU's Foreign Delegation Visit Request Form,
below.
The point of contact (POC) for Foreign Delegation visits to NDU is the International Student
Management Office / Ms. Catherine Tappert: c.a.tappert.civ@ndu.edu , 202-685-4075

Email Address:

Please list your FVR number:

What is the date of your visit?

What is the name of your group?

How many people are in the delegation?

Please list the name, rank, and tile of the head of your delegation:

Please list the name, rank, and title of the members of the delegation:

Will the delegation bring a gift?
Yes
No
If so, what will the gift be? (Please note that NDU prefers no gifts, though we
leave this decision to the delegation.)

What uniform will the delegation wear? Be specific.

Does the delegation speak English?
Yes
No
If not, will the delegation bring an interpreter?
Yes
No
Where else will the delegation visit on their visit to the US?

Please list the type (sedan, van, coach bus) and number of vehicles the delegation will use.

Please select the delegation's purpose(s) for the visit. Please note that NDU will do its best
to accommodate the delegations' interests based on availability of staff and resources.
Check any that apply:
Meeting with NDU Leadership
Professional Military Education Briefing
Round-table discussion with NDU subject matter experts
Meeting with NDU International Fellows from the visiting nation
To discuss enrolling officers from visiting country to NDU programs in the future
Other
Who in the delegation has visited NDU previously? Please list their names as well as the purpose
for their prior visit.

What else would you like the NDU International Visits Coordinator to know prior to your visit?