FORM 301.pdf

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INDUSTRY DAY SITE VISIT on 14 and 15 May 2025 for the Above Ground Construction Services Contract (CSC) pre solicitation
Solicitation number
HDTRA225RE0010005
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The document is a White Sands Missile Range Access Badge (WAB Badge)/Up-Range Request Form for CPTC construction activities. The form is prescribed under Army Regulation 190-13 and WSMR Visitor Control Policy 2024, issued by the Directorate of Emergency Services-Physical Security. The form requires detailed personal information for accessing White Sands Missile Range, including legal name, CAC card status, organization, up-range access, and visit dates. The specific request is for access from 24AUG2024 to 26AUG2024, sponsored by LT Elisabeth C McClung from DTRA, with a purpose of CPTC construction. Sponsoring organizations must ensure all personnel receive a UXO (Unexploded Ordnance) Briefing before requesting up-range access, and the completed form should be submitted to a designated military email address for physical security approval.

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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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Middle Name or NA if noneRow1:
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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
Date12_af_date:
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