Utilize the following form to submit an official off reservation request for travel, additional requests by email or fax or phone will not be regarded as an official request. 

Please provide all details and each section is required for submission. Please upload all documents for complete review and response. You will receive confirmation of submission and update by email. At this time 5/22 remember the criteria for ORT – see memo here

“• Alternate no-contact mechanism has been exhausted (video conferencing, teleconferencing, etc.)
• Extraordinary critical attention necessary to maintain operable government services
• Job duties and responsibilities will be critically impacted”

If you are requesting for updates or have questions about this submission form, please email Tia Yazzie (tia.yazzie@nndcd.org) or call us at 928-871-7182. Thank you!

Off Reservation Travel

General ORT Submission forms
First and last name of requesting individual
Email(Required)
Official and valid email - no group email accounts.
Position Title
Requesting Chapter or Dept
First and last names of all traveling
Contact phone number for questions, must be valid for questions regarding each request.
What is the destination location of your travel?
Transportation type
What is the purpose of your travel? Meeting, Conference, etc...
Please indicate precautions during travel: individual vaccinations, masks, social distancing, etc.
Documents need to be submitted
Please check off all documents submitted to complete full packet for request
Drop files here or
Accepted file types: jpg, png, pdf, Max. file size: 512 MB, Max. files: 7.