Visitor Authorization List.pdf

VISITOR AUTHORIZATION LIST - FOR OFFICIAL USE ONLY

PERSONAL DATA – PROTECT IN ACCORDANCE

WITH THE PRIVACY ACT LAW OF 1974

VISITOR AUTHORIZATION LIST - FOR OFFICIAL USE ONLY

PERSONAL DATA – PROTECT IN ACCORDANCE WITH THE PRIVACY ACT LAW OF 1974

EVENT: Site Visit – Construction Project (Solicitation #FA8201-11-B-0006)

DATE OF EVENT: Thursday, 28 April 2011

TIME OF EVENT: 9:00am (MST) – 2:00 (MST)

LOCATION OF EVENT: Meet at Hill Aerospace Museum Theater–Escorted to MAMS II Area

PERSONNEL ATTENDING EVENT

*Each attendee must have State or Federal issued picture ID on day of site visit for access to Hill AFB, UT.

This form must be completed for your 3 attendees and submitted via email to shelly.karcheski@hill.af.mil no later than 21 April 2011, 2:00 pm (MST).

ATTENDEES NOT CLEARED PRIOR TO THE SITE VISIT WILL NOT BE ALLOWED ENTRY.

PRIME CONTRACTOR COMPANY NAME

(Please Print Company Name)

LAST NAME FIRST NAME

STATE OR FEDERAL ISSUED PICTURE ID

(i.e. Driver License)

COMPANY NAME

Document Type

(i.e. Driver License) Document Number

Picture ID Issued By

State Country mailto:shelly.karcheski@hill.af.mil