SECURITY_FORCES_REGISTRATION_FORM.DOCX

REGISTRATION FORM

Mission & Installation Contracting Command (MICC) – Fort Bliss, TX Security Forces 13 March 2019

Business Information:

Company Name: ______________________________________________________________________

Company Cage Code: ___________________

Company Address: _____________________________________________________________________

Business Phone Number(s): ______________________________________________________________

ALL ATTENDEES MUST BE REGISTERED, THIS WILL BE STRICTLY ENFORCED.

**Please note Contractor attendees will be limited to three (3) individuals per company to include any subcontractors due to limited room capacity**

This Industry Day is scheduled to start at 0800 MST on 13 March 2019.

You must pre‐register for this conference by e‐mailing your completed registration and information release form no later than 06 March 2019 @ 0900 MST to SSG Sara Craig at sara.l.craig2.mil@mail.mil.

NOTE: Save this as a pdf file and email to the above address.

Please see the attached release form for placing company information on FedBizOpps at www.fbo.gov.

Please see the attached personal registration forms.

Would you like to schedule a One‐on‐One Meeting with the Government? (Y/N): ________

Release of names and information of the Security Forces Industry Day attendees:

We typically share company names and attendees list including: telephone numbers and email addresses with other attendees from the Industry Day to facilitate subcontracting and teaming arrangements.

Before releasing the above named information to all Industry Day attendees on FedBizOpps at www.fbo.gov, we would like your authorization to do so. If you do not want such information to be distributed, perhaps there is a corporate or office email and telephone number that may be used instead. Whatever information you agree to release to FedBizOpps will be information we provide to all attendees.

Please state whether we can release your name, title, telephone number and e‐mail address in association with your attendance at the SECURITY FORCES Industry Day in El Paso, TX.

YES: _____ NO: _____

If you answered NO to the above, is there any information we can share with all attendees?

Signature to authorize release of information

Personal Information:

· A Personal Information form must be completed for each Industry Day attendee.

Name of Representative (Last, First, Middle): _____________________________________________

Title: _______________________________________________________________________________

Work Phone: _________________________________________________________________________

Email: ______________________________________________________________________________