FACILITY PRE CHECK-IN

SESSION 30:00

Identity Verification & Visit Registration

01 /AcknowledgementsiPENDING

False Statement Notice I understand that providing false, fraudulent, or misleading information on this form — or to any facility security or administrative personnel in connection with this visit — is a federal offense under 18 U.S.C. § 1001, and may additionally constitute a violation of 42 U.S.C. § 2273. Such conduct may result in immediate denial of access, removal from the premises, referral to federal law enforcement, and/or criminal prosecution. Data Processing, Biometric Collection & Retention Policy I consent to the collection, processing, and retention of my personal and biometric information — including photographic images, facial recognition data, fingerprints, and government-issued identity credentials — by Alpha Nur and applicable U.S. government agencies upon entering facility grounds and throughout the duration of my visit. I understand this processing is conducted for security, access control, and regulatory compliance purposes pursuant to applicable federal law, including the Privacy Act of 1974 (5 U.S.C. § 552a), DOE Order 470.4B, NRC regulatory requirements under 10 C.F.R. Part 73, and Alpha Nur's Privacy Policy. I understand that biometric data collected on-site may be shared with federal law enforcement and security agencies as required by law or applicable security directives. Prohibited Articles & Conduct Certification I certify that I am not bringing onto the premises any prohibited articles, including: firearms, ammunition, explosive devices, or weapons of any kind; illegal controlled substances; and any other item prohibited under federal law, facility security directives, or applicable NRC and DOE security orders. I further certify that I will not engage in prohibited conduct, including: attempting to access any area of the facility without escort or authorization; photographing, sketching, or otherwise recording restricted areas or equipment; interfering with or impeding facility security personnel in the performance of their duties; and any conduct that constitutes tampering, sabotage, or attempted sabotage of nuclear materials, facilities, or security systems. I understand that all persons and their belongings are subject to search upon entry and at any time while on the premises, and I consent to such inspections. Violations may constitute federal offenses under 18 U.S.C. § 1030, 42 U.S.C. § 2272, 42 U.S.C. § 2278a, and 18 U.S.C. § 111. Visitor Access Conditions & Facility Authority Notice I understand that access to this facility is conditional and may be denied, suspended, or revoked at any time, with or without stated cause, at the sole discretion of Alpha Nur security personnel. I agree to immediately comply with all escort instructions, safety directives, and security orders issued by Alpha Nur personnel or authorized contractors while on the premises. I understand that failure to comply with lawful security instructions may result in my detention pending the arrival of law enforcement, and/or referral to federal, state, or local law enforcement agencies. I acknowledge that this is an armed facility and that Alpha Nur and its designated security contractors are authorized to employ lawful use of force to ensure compliance with facility security policies and applicable federal law, including 10 C.F.R. Part 73 and DOE security orders issued under the Atomic Energy Act of 1954 (42 U.S.C. § 2011 et seq.). I understand these conditions apply from the moment I enter facility grounds. Photography, Recording & Mobile Device Policy I acknowledge that photography, audio/video recording, and the use of mobile devices (including smartphones, tablets, smartwatches, and any device capable of capturing images or audio) are restricted or prohibited in designated areas of this facility in accordance with facility security directives and applicable federal security orders. I understand that certain areas may not permit any electronic devices, and that I should not bring onto the premises any device I am not prepared to surrender temporarily or leave unsecured. Alpha Nur and its security personnel bear no liability for any personal electronic device that is lost, damaged, confiscated, or destroyed in connection with facility security requirements. My use of any recording device in violation of facility policy may constitute a federal offense under 18 U.S.C. § 1030, and may be subject to additional penalties under 42 U.S.C. § 2272 and applicable DOE security orders. Export Control Certification I certify that I am a U.S. person as defined under 22 C.F.R. § 120.62, or that I hold valid authorization under applicable U.S. export control regulations, including the International Traffic in Arms Regulations (ITAR, 22 C.F.R. Parts 120–130), the Export Administration Regulations (EAR, 15 C.F.R. Parts 730–774), and DOE regulations governing assistance to foreign atomic energy activities (10 C.F.R. Part 810). I understand that unauthorized disclosure of controlled technology or information during my visit may constitute a federal offense subject to criminal and civil penalties.

02 /Biographical InformationiPENDING

🔒 Complete Acknowledgements to unlock this section.

Organization *

Organization Title *

Organization is not U.S.-incorporated

Organization has an ultimate parent organization

Correspondence Email *

Correspondence Phone *

Citizenship(s) *

Select all citizenships that apply. Required for security vetting and U.S. export control compliance, including 10 C.F.R. Part 810.

03 /Identity VerificationiPENDING

🔒 Complete Biographical Information to unlock this section.

Verify Your Identity

Use the digital ID on your phone — confirmed with your biometrics.

REAL ID–compliant State IDs or a passport only — non-compliant documents will not be accepted for facility access. Verified details are kept encrypted for your visit record and retained as described in our Privacy Policy and required by federal law.

Identity Information

Manual Identity Entry

State ID / Driver's License

First Name *

Your license’s “Given names” line includes first and middle names — enter only your first name here.

Family Name *

Middle Name * No middle name

Date of Birth *

Sex *

Street Address *

Apt / Unit

City *

State / Territory *

ZIP Code *

My address doesn't fit this format (non-standard or non-U.S.)

License / ID Number *

Issuing State / Territory *

Issue Date *

Expiration Date *

Height *

FTIN

REAL ID *

04 /Visit DetailsiPENDING

🔒 Complete Identity Verification to unlock this section.

Alpha Nur Host *

Provide your facility host’s @alphanur.com email address.

Anticipated Visit Date *

Multi-day visit

Purpose of Visit *

Select all that apply.

Scheduled Meeting Contractor / Maintenance Delivery Interview Tour Audit / Inspection Research / Technical Collaboration Other

Sensitive Visit Certification⚠︎ READ CAREFULLY I certify that I anticipate my upcoming visit to include access to nuclear facilities or restricted areas, and/or a classified visit in which classified information may be observed or discussed. I consent to verification via DISS, DOE eDISS+, and NBIS or successor systems. See the Privacy Policy.

Social Security Number *

Your SSN is collected solely to perform the federal security vetting required for sensitive visits and is encrypted. If not provided, this visit cannot be processed as a sensitive visit.

Nuclear Facility Visit Certification I certify that I anticipate my upcoming visit to include access to nuclear facilities or restricted areas.

Classified Visit Certification I certify that classified information is anticipated to be observed or discussed during my visit. Classified access details are required below.

Electronic Medical Device Declaration⚠︎ READ CAREFULLY I anticipate having on my person during the visit one or more Electronic Medical Devices (EMDs) that transmit data through Radio Frequency (RF) means, including Wi-Fi, Bluetooth, or cellular — such as a pacemaker, insulin pump, continuous glucose monitor, or similar implanted or wearable device.

05 /Accuracy CertificationiPENDING

🔒 Complete Visit Details to unlock this section.

By signing below, I certify that all information I have provided in this form is true, accurate, and complete to the best of my knowledge. I understand that knowingly providing false or misleading information may result in denial of access, removal from the premises, and/or referral to appropriate authorities.

I further understand that should any information declared in this form change prior to my visit — including changes in purpose of visit, employer, anticipated access needs, or the items I will have on my person — I will promptly contact my Alpha Nur host to inform them of the change, so that appropriate security and administrative adjustments can be made.

Full Legal Name *

Typing your full name constitutes your electronic signature.

* REQUIRED FOR SUBMISSION

Before you can submit

Verified identity details are kept encrypted and retained only as long as necessary to administer your visit and meet security obligations under applicable federal law, DOE directives, and Alpha Nur's agreements with the U.S. Department of Energy. See our Privacy Policy for details.

✓

Pre Check-In Submitted

REF: —

ALPHA NUR
VISITOR PASS

Visitor

Visitor Name

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Date of Birth

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Citizenship

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Title

—

Organization

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Visit

Host

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Visit Date

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Purpose

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ID Verification

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Submission Date

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Certification

Certified By (Electronic Signature)

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Before Visit Date

Pre-Screening ReviewAllow up to 3 business days for Alpha Nur to review your submission. If your visit is scheduled sooner and you have not received confirmation, contact your host directly. You will be notified at the email address you provided once pre-screening is complete.

Date of Visit

Bring Your Registered IDPlease present the exact same government-issued ID you registered in this form. Substitute IDs may not be accepted at check-in. If you verified with a digital ID, bring the physical card or passport it was issued from in case there are technical difficulties.

Dress CodeApplies to all on-site visitors: long pants, sleeved shirts, and closed-toe, closed-heel shoes; natural fibers (e.g., cotton, wool; leather acceptable); badge attached and visible at all times.

Open Wounds & Skin ConditionsVisitors with open wounds or significant skin conditions must notify security on arrival. All wounds must be fully covered. Entry into radiological or contamination-controlled areas may be denied if wounds cannot be adequately protected.

On Arrival

Arrive at the main entrance with your registered ID and confirmation number. Present your ID to the security officer, who will verify your identity and locate your pre-registration record.

A visitor badge will be issued upon check-in. Wear it visibly at all times and return it to the security desk upon departure.

Do not proceed beyond the reception area unescorted. Your Alpha Nur host or assigned escort will meet you.