Base Access.docx

14 KB Posted

Attached to
Aircraft Wash Services
Solicitation number
W50S8523Q0016
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SELFRIDGE AIR NATIONAL GUARD BASE ACCESS FORM

Pre-registration is MANDTORY for access to the base. Please email the completed word version Base Access Form to allow for copy and paste.

Email to TAMI.MCKENNEY.1@US.AF.MIL

Add to the Subject Line: W912JB-23-Q-0016 Aircraft Wash Services Site Visit

Authorized Visitor Information complete for each person who will be attending:

Full Name: Last, First, Middle: __________________________________________

JR/SR: _______________________________________________________________

Date of Birth:__________________________________________________________

Driver’s License (State of issue and number)_________________________________

Country of Citizenship/ If not USA Passport Number ____________________________________

Destination on base:

43200 Maple St, Building 105, Selfridge ANGB, Michigan, 48045

Full Name: Last, First, Middle: __________________________________________

JR/SR: _______________________________________________________________

Date of Birth:__________________________________________________________

Driver’s License (State of issue and number)_________________________________

Country of Citizenship/If not USA Passport Number____________________________________

Destination on base:

43200 Maple St, Building 105, Selfridge ANGB, Michigan, 48045

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