NASCC Guest Sponsorship for MPI.xls

XLS spreadsheet 34 KB Posted

Attached to
Solicitation for Magnetic Particle Inspection (MPI) System
Solicitation number
W912NW23Q0057
Issued by

About this file

This guest sponsorship request form documents a request to sponsor guests for access to Naval Air Station Corpus Christi in Texas from July 20th to July 21st 2023. The purpose of the guest access is to support a site visit related to the Magnetic Particle Inspection System solicitation issued by the Department of the Army Materiel Command Contracting Command at Redstone Arsenal. The request lists the sponsor's name and contact information and includes fields to provide details on up to 15 guests, including their full name, Social Security number, driver's license information, date of birth, and phone numbers. The form notes it takes three working days to process and that guest sponsorship privileges can be revoked if base policies or federal statutes are violated. It requires signatures from the sponsor and an approver.

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FRONTPAGE

NAS CORPUS CHRISTI
GUEST SPONSORSHIP REQUEST
PLEASE CHECK THE APPROPRIATE BOXES TO INDICATE YOUR AFFILIATION TO THE BASEACTIVERESERVEDEPENDENTRETIREDCIVILIAN
SPONSOR: LAST NAME, FIRST NAME Flores, Davidx
TO: SECURITY OFFICER, NASCCDATES OF EVENTHOME NUMBER
20 July 202320 July 2023
TYPE OF FUNCTION:HOURS OF EVENT
Site Visit in support of Magnetic Particle Inspection System (MPI)9:00 am11:00 pmCELL NUMBER
NUMBER OF GUESTS361-438-3984
LOCATION
Corpus Christi Army DepotWORK NUMBER:
361-961-7101
NAMEFULL SSN #DRIVER LICENSE & STATE OF LICENSEDATE OF BIRTHHOME/CELL PHONE
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Guest sponsors are responsible for any abuse that may arise from the guest's use of their credentials to access this installation. The guest sponsorship request takes (3 )working days to process. You should feel confident that a guest will honor and use this privilege in a responsible manner. Please take the time to communicate all of the policies that you observe while on this installation with each guest. Please be advised that your guest sponsorship privileges can be revoked if a guest is found in violation of base policies or federal statutes.
Sponsor's Signature X__________________________________________
SIGNATURE OF APPROVAL: Martin Wheeler
BY DIRECTION OF SECURITY OFFICER
X__________________________________________DATE:
FOR OFFICIAL USE ONLY - PRIVACY SENSITIVE - Any misuse or unauthorized disclosure can result in both civil and criminal penalties. PRIVACY ACT STATEMENT AUTHORITY: Executive Order 10450, 9397; and Public Law 99-474, the Computer Fraud and Abuse Act. PRINCIPAL PURPOSE: To record names, signatures, and Social Security Numbers for the purpose of validating the trustworthiness of

Individuals requesting access to Department of Defense (DoD) systems and information. NOTE: Records will be maintained in paper form. ROUTINE USES: None. DISCLOSURE : Disclosure of this information is voluntary; however, failure to provide the requested information may impede, delay or prevent further processing of this request.

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