FORM 301.pdf

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Attached to
INDUSTRY DAY SITE VISIT on 14 and 15 May 2025 for the Above Ground Construction Services Contract (CSC) pre solicitation
Solicitation number
HDTRA225RE0010006
Issued by

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The document is a White Sands Missile Range Access Badge (WAB Badge)/Up-Range Request Form for obtaining site access. The form is designed for individuals requesting access to White Sands Missile Range, with a specific purpose noted as "CPTC construction". The form requires detailed personal information, including legal name, CAC card status, organization, and up-range access dates (24AUG2024 to 26AUG2024). The sponsoring official is LT Elisabeth C McClung from DTRA (Defense Threat Reduction Agency), with a contact phone number of 505-353-4040 and email elisabeth.c.mcclung.mil@mail.mil. A critical requirement is that all personnel must receive a UXO (Unexploded Ordnance) Briefing before requesting Up-Range access, and the completed form should be submitted to usarmy.wsmr.imcom.mbx.physical-sec@army.mil.

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File Type Posted
Amend 0001 Industry Day Agenda Overview and Access on 14MAY 2025.pdf PDF
Amend 0001 HDTRA225RE001 RFP 23APR2025.pdf PDF
Visitor-Prenotification-Form.pdf PDF
NEW FORM 300.pdf PDF

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White Sands Missile Range Access Badge (WAB Badge)/Up-Range Request Form

PRESCRIBING REGULATION: ARMY REGULATION 190-13; WSMR VISITOR CONTROL POLICY 2024

PROPONENT: DIRECTORATE OF EMERGENCY SERVICES-PHYSICAL SECURITY

Privacy Act Statement

AUTHORITY: 10 U.S.C. 3013; 44 U.S.C. 3103; Army Regulation 190-13, Army Physical Security Program; and WSMR Visitor Control Policy 2024.

PRINCIPAL PURPOSE: To determine suitability of individual(s) requesting access to White Sands Missile Range. This information will be sued to generate state and federal criminal history record checks.

ROUTINE USE(S): Personal information may be disclosed to appropriate military and civilian emergency and investigation agencies to assist in determining suitability for access to White Sands Missile Range.

DISCLOSURE: Voluntary. However, failure to provide information could result in the refusal to access White Sands Missile Range.

Legal Name as Appears on Driver’s License of State ID.

Example: John Robert Doe

Yes DES Yes 24AUG2024 26AUG2024

Last Name First Name Middle Name or NA if none

CAC Card Yes/No

Organization Up Range Yes/No

Begin Date End Date

Purpose for Visit

Sponsor or Requester Information

Name of Sponsoring/Requesting Official: Name of Sponsor Organization:

Sponsor’s Phone Number: Sponsor’s Email: Date of Request:

(DES USE ONLY) Physical Security Approval: Approval Date:

When complete submit to: usarmy.wsmr.imcom.mbx.physical-sec@army.mil

WSMR FORM 301 JULY 2024

*Sponsoring organizations must ensure that all personnel will have UXO Briefing before requesting Up-Range access.

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Purpose for Visit: CPTC construction
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Text7: LT Elisabeth C McClung
Text8: DTRA
Text9: 505-353-4040
Text10: elisabeth.c.mcclung.mil@mail.mil
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