Attachment 4-Registration Access Request.pdf

Controlled Unclassified Information (CUI) when form is completed

The information herein is For Official Use Only (CUI) which must be protected under the Freedom of Information Act of 1966 and Privacy Act of 1974, as amended. Unauthorized disclosure, misuse or release outside of law enforcement of this PERSONAL INFORMATION may result in criminal and/or civil penalties.

McConnell AFB Contracting Squadron Site Visit – 8 May 2026

REGISTRATION AND ACCESS REQUEST

Contractors shall provide the information below and sign on the second page acknowledging receipt of the access instructions. Form shall be submitted to the following email addresses via encrypted means:

torrin.black@us.af.mil, lindsay.manning.1@us.af.mil and wesley.neaves@us.af.mil. Please return the completed form NLT 1000 AM CST on 1 May 2026. Late submissions will not be able to be accommodated.

Company Information

Company Name: _______________________________________

Type of Business: ______________________________

Cage Code: __________________________________

Point of Contact info for Registration/Access issues:

Name: ____________________ Phone Number: ________________ Email: ______________________

Attendee Information

Attendee 1: __________________________________

Attendee 2: __________________________________

The following information is required to make the necessary arrangements for Base Access. Please complete all fields, as all information is necessary for the Government to perform the necessary checks to approve access. If an individual does not have a middle initial, please indicate N/A after their First Name

Last Name First Name & Middle Initial Date of

Birth DL, Permit or State

ID #

State of

Issue Social Security

Number

The information contained above will be utilized only to allow Security Forces to perform a Criminal History Background check. Access to the sensitive information will be limited to the individuals who collect the information from the Contracting Office, and the Law Enforcement individual(s) that complete the background information.

Sensitive information provided will be destroyed upon completion of the event and will not be retained. If any issues are noted that will prevent someone from being granted access to the facility, the Company POC listed above will be contacted and advised that the individual has been denied access along with contact information to get additional

The information herein is For Official Use Only (CUI) which must be protected under the Freedom of Information Act of 1966 and Privacy Act of 1974, as amended. Unauthorized disclosure, misuse or release outside of law enforcement of this PERSONAL INFORMATION may result in criminal and/or civil penalties.

details if the individual so desires. Any information on why the individual has been denied access will only be provided to the individual involved by the law enforcement officer performing the background checks, so please do not expect the person who contacts your POC to be able to explain why the individual was denied access, as they will not have that information.

Access Instructions

The event will be sponsored by the 22nd Contracting Squadron at McConnell AFB. All personnel will meet at the Visitor Center parking lot. Arrangements will be made for guests to begin arriving at the East Gate No Earlier than 9:00 am and departing the installation No Later than 12:00 pm on 8 May 2026. If a drivers license does not have the necessary star indicator on it, then the individual will be required to submit additional documentation. If multiple people arrive in the same vehicle, they must all present the necessary Real ID and be on the access list/registered.

Individuals will not be granted access if they do not have Real ID compliant documents or are not on the approved access list. Additionally, Gate guards may take action necessary to ensure that your vehicle is legally registered before gaining access, this could include them asking for registration documentation or rental agreements. Please provide the guard with any necessary information that is requested if feasible. If there are any issues, and you need assistance please call 316-759-3275, the Contracting Office Front Office and appropriate personnel will be sent to the gate to provide assistance if possible.

Drivers are responsible for ensuring that all passengers wear seatbelts at all times. Drivers are required to follow all posted speed limits and Traffic Regulations. Max Speed limit in the areas that individuals will have access to is 30 MPH. Drivers are prohibited from using their cell phone while driving on the base unless utilizing a hands-free device. Firearms and contraband such as bullet casings and drugs are prohibited on the installation, so please ensure any vehicle utilized does not contain any of the items. The government reserves the right to search vehicles that are accessing the base.

I, _________________________________ of ________________________________, acknowledge receipt of the Access Instructions.

Signature

REGISTRATION AND ACCESS REQUEST