The In-Person Event Gov’t Participant Registration

Which event are you participating in? *

Name *

First

Last

Rank/Title

Organization *

Work Email *

Personal Email

Phone *

Do you agree to share your basic contact information with other participants in this project? *

Do you have a valid CAC? *

If Yes, please provide your CAC Expiration below. In No, please provide your driver license information below for base access.

CAC Expiration Date *

Please enter your CAC expiration date.

Date of Birth *

Driver's License # *

Please include your full driver license numbers (Letter and Numbers)

State of Issuance *

Will you register for or opt out of meals? *

1. Submit your collateral (Non-SCI) clearance if applicable to the following JPAS SMO Code: US0BF4FW6

POC information:

Jojo Balmaceda

Cell 719-551-6795

2. If JPAS or DISS is not available, organization security manager will provide a memorandum stating the following information:

Submit signed memorandum via email at SSR_USAFA@usafa.edu

How will you attend this event? *

For virtual attendees, you will receive any links and access tools via email prior to the event.

The In-Person Event Gov't Participant Registration