Base_Access_18Q5039.docx
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- Corrosion Prevention & Control
- Solicitation number
- W912JB-18-Q-5039
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Base Access Form
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Attachment 1
SELFRIDGE AIR NATIONAL GUARD BASE ACCESS FORM
Pre-registration is MANDTORY for access to the base. Email Access Form.
Email to katherine.a.sutton.civ@mail.mil
Add to the Subject Line: W912JB-18-Q-5033 Airfield Insecticide
Authorized Visitor Information complete for each person who will be attending:
Full Name: Last, First, Middle: __________________________________________
JR/SR: _______________________________________________________________
Date of Birth:__________________________________________________________
Driver’s License (State of issue and number)_________________________________
Gender and Race_______________________________________________________
Country of Citizenship/Passport Number____________________________________
Destination on base: 127 MSC Contracting Division, Bldg 105
Full Name: Last, First, Middle:___________________________________________
JR/SR: _______________________________________________________________
Date of Birth:__________________________________________________________
Driver’s License (State of issue and number)_________________________________
Gender and Race_______________________________________________________
Country of Citizenship/Passport Number____________________________________
Destination on base: 127 MSC Contracting Division, Bldg 105
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