CODDS Industry Day Registration FormR1.pdf

Industry Day Registration , 2023

1. COMPANY NAME:

2. ADDRESS:

3. CITY: 4. STATE 5. ZIP CODE

6. ATTENDEE NAME #1:

7.TITLE

8.WORK TELEPHONE NUMBER:

9. WORK EMAIL ADDRESS:

10. ATTENDEE NAME #2:

11.TITLE

12.WORK TELEPHONE NUMBER:

13. WORK EMAIL ADDRESS:

14. ATTENDEE NAME #3:

15. TITLE

16. WORK TELEPHONE NUMBER:

17. WORK EMAIL ADDRESS:

. Participating as Prime, Subcontractor, or Joint venture:

. Do you grant permission to include your information on the attendee list?

Attendee list will be emailed to all attendees after the Industry Day event

Note One–on-one sessions for potential rime ontractors will be from 1300

– 1700 on , 2023

Limited to 30 minutes each, one session per company Sessions will be scheduled on a first come, first served basis Please request a time slot with submission of request form: (1300-1330;

1335-1405; 1410-1440; 1445-1515; 1520-1550; 1555-1625; or 1630-1700)

*interested companies will be contacted if additional sessions are needed

**IT IS THE ATTENDEE(S) AND THEIR COMPANY SECURITY

OFFICE’S RESPONSIBILITY TO ENSURE EACH ATTENDEE HAS A

VALID AND UPDATED VISIT AUTHORIZATION REQUEST (VAR) ON

FILE WITH THE MDA SECURITY OFFICE

No

No

No

1 . ATTENDEE NAME # :

1 .TITLE

. WORK TELEPHONE NUMBER:

. WORK EMAIL ADDRESS:

No

Yes No