KSC_Form_28-1222.pdf

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KSC Visitor Pass Request KSC FORM 28-1222 NS (PI) 03/15 (1.1) PREVIOUS EDITIONS ARE OBSOLETE. Validate prior to use.

NRRS 1/114.A.1

Page of 11.0.0.20130303.1.892433.887364 KSC Visitor Pass Request Request visitor access to KSC KSC FORM 28-1222 Rev 03/15, Created 12/13 Version 1.1 12/13 KSC Forms KSC Visitor Pass Request 03/15 1.1 Fax No. 867-4854 Fax Number 867-4854 Mail Code: KSC Badging Office Phone No. 867-7763 Phone Number 867-7763 Phone Number 867-7763 Visitor Information Badging Official Information By my signature, I have confirmed with the requestor the validity of this visit.

WARNING. When filled in, this form contains Personally Identifiable Information (PII) that is subject to Federal law and regulation. PII may be used only as authorized, which includes securing it in accordance with NASA policy and procedural requirements. Penalties for misuse apply. Report suspected misuse immediately to Security Operations Center at 877-NASA-SEC (627-2732).