The In-Person Event Academia Participant Registration -

Which event are you participating in? *

Basic Information

Name *

First

Last

Organization *

Email *

Phone *

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

Base Access

Do you have a valid CAC? *

Yes
No

CAC Expiration Date *

Date of Birth *

Driver's License # *

State of Issuance *

Are you a U.S. Citizen? *

Yes
No

Other Information

Will you opt in to catered meals, snacks, and beverages? *

Please visit the provided EventBrite link to register and pay for meals if you choose to opt in. You may find the meal ticket by searching the event name on EventBrite if a link has not been sent to you directly.

Do you have any dietary restrictions? *

Please list so we can make appropriate accommodations. *

Please list any snack or beverage requests here. *

We will do our best to accommodate preferences.

Do you have a current U.S. National Security Clearance? *

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:

Full Name
SSN
Eligibility
Investigation
Citizenship
Agency or Organization
Date of Visit
Purpose of Visit

Submit signed memorandum via email at SSR_USAFA@usafa.edu