NSSL Industry Day Participant Request Form
Date and Time:
28 February 2023:
- General Session: 0800-1200 PDT
- One-on-One Sessions: 1300-1600 PDT
1 March 2023: One-on-One Sessions (if necessary)
Location:
Space Systems Command
Gordon Conference Center (GCC)
483 North Aviation Blvd
El Segundo, CA, 90245
Company
Name:
Company POC:
(name/email)
Identify In Person Participants for Industry Day (Maximum of 5):
Full Name: Last, First, Middle Date of Birth
Drivers License / State
Last 4 SSN
(Please note any non-U.S. Citizens will not be allowed to attend this Industry Day)
Please adhere to the example below when entering In Person Participant information:
NOTE: We cannot accept drivers license or state IDs that indicate FEDERAL LIMITS APPLY
per REAL ID ACT of 2005. A person in possession of such document must have another form of
picture identification such as a US passport. People listed MUST be US Citizens.
Last Name, First Name, Middle Name: SCOTT, TYLER ROBERT (NOT BOB)
Date of Birth: MONTH/DAY/YEAR (Ex: 06/28/1978)
Drivers License Number and State: All Numbers, Letters and State of Issuance must be
included (Ex: X01234567 CA).
Last 4 of Social Security Number (SSN): Mandatory for All In Person Participants
Potential Phase 3 Launch Service Providers One-on-One Session:
The Government considers a potential Phase 3 Launch Service Provider to be any space access company
with an existing and/or planned launch system capable of lifting a NSSL-class payload to orbit.
Check box if requesting a One-on-One discussion after the general session?
Additional Comments:
Please fill out and return this form to Mr. Greg Pierson at gregory.pierson@spaceforce.mil and
Capt Foster Davis at foster.davis@spaceforce.mil no later than 1300 PDT on 21 February 2023.
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