Alpha Nur Visitor Pre Check-In

Identity & Visit Registration

Acknowledgements

Biographical

Identity

Visit Details

Background Check

Certify & Submit

Acknowledgements Step 1 of 6

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 but not limited to 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 but not limited to: 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.

All six acknowledgements required to proceed

Biographical Information Step 2 of 6

Organization *

Organization Title *

Organization is not U.S.-incorporated

Organization has an ultimate parent organization

Ultimate Parent Company *

Ultimate parent company is not U.S.-incorporated

Correspondence Email *

Correspondence Phone *

Citizenship(s) *

Select all citizenships and nationalities. List all that apply. This information is required for security vetting, background adjudication, and compliance with DOE regulations governing cleared facility operations, including 10 C.F.R. Part 810 and applicable security orders.

Identity Verification Step 3 of 6

Present Digital ID or Mobile Driver's License

Use a supported digital wallet or state-issued digital ID to verify your identity. Your device will prompt biometric confirmation before any data is shared. Your document must be REAL ID compliant — non-compliant documents will not be accepted for facility access.

Identity Verified

Requires a supported mobile ID including a state ID, driver's license, or passport on your device. See your wallet app for compatibility.

I will enter my information manually

Identity Information Manual Identity Entry

Document Type *

State ID / Driver's License

U.S. state-issued document

Passport

Any country passport

Select a document type above to continue.

Given Name *

Family Name *

Middle Name * No middle name

Date of Birth *

Sex *

Residential Address *

License / ID Number *

Issuing State or Territory *

Issue Date *

Expiration Date *

Eye Color *

Hair Color *

REAL ID *

Height *

ft in

Weight *

lbs

Given Name *

Surname *

Middle Name * No middle name

Date of Birth *

Sex *

Country of Citizenship *

Place of Birth *

Passport Number *

Issuing Country *

Date of Issue *

Date of Expiry *

Visit Details Step 4 of 6

Alpha Nur Host *

Provide the @alphanur.com email address of your Alpha Nur host at this facility.

Anticipated Visit Date * Multi-day visit

Purpose of Visit *

Select all that apply.

Sensitive Background Check Step 5 of 6

Access Certification I certify that I anticipate my upcoming visit to include access to nuclear facilities, restricted areas, and/or the observation or discussion of classified information, and I consent to Alpha Nur verifying all information provided in this submission — including the identity and security information below — against applicable federal security systems, including the National Instant Criminal Background Check System (NICS), the Defense Information System for Security (DISS), the DOE Integrated Security System Plus (eDISS+), and the National Background Investigation Services (NBIS), as required for the nature of this visit. This processing is conducted in accordance with Alpha Nur's Privacy Policy.

Social Security Number *

DOE Access Authorization *

National Security Eligibility *

FSO Visit Authorization Request (VAR) Certification * I certify that my Facility Security Officer (FSO) has submitted a Visit Authorization Request (VAR) for this visit to Alpha Nur via DISS and/or eDISS+ prior to this submission. I understand that access will not be granted without a confirmed VAR on file.

Need to Know Justification *

0 / 500

Site Access Health & Safety Certification I understand the following site access requirements: Dress Code: Wear long pants, shirts with sleeves (no tank tops or sleeveless tops), and closed-toe, closed-heel shoes. Shorts, skirts and dresses, sandals, and high heels are prohibited on site. All clothing must be made from nonsynthetic, natural fibers (e.g., cotton, wool, leather) and must allow for secure badge attachment. Open Wounds & Skin Conditions: Visitors with open wounds, sores, cuts, or significant skin conditions must notify site security before entry. All wounds must be fully covered. Entry into radiological or contamination-controlled areas may be denied if wounds cannot be adequately protected and approved by Radiation Protection personnel.

HSPD-12 Credential Certification I certify that I will bring my Homeland Security Presidential Directive 12 (HSPD-12) compliant credential — also known as a Common Access Card (CAC), Personal Identity Verification (PIV) card, or equivalent federal smart card — if classified information is anticipated to be observed or discussed during my visit. I understand that access to classified areas may not be granted without presentation of a valid HSPD-12 credential.

⚠ Declaration — not a routine certification. Read carefully before ticking. Electronic Medical Device Declaration 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 but not limited to Wi-Fi, Bluetooth, or cellular — such as a pacemaker, insulin pump, continuous glucose monitor, or similar implanted or wearable device. I understand that an Alpha Nur security representative may contact me prior to the visit to conduct a security assessment and coordinate any necessary accommodation in accordance with facility RF policy.

Accuracy Certification Step 6 of 6

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 but not limited to 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.

Type Your Full Legal Name to Sign *

Typing your full name constitutes your electronic signature for the purposes of this pre-registration submission.

Submitted data is handled in accordance with Alpha Nur's Privacy Policy and applicable federal security regulations.

* Required for submission

Pre Check-In Submitted

Your pre-screening submission has been received. Alpha Nur will review your information and send a confirmation of pre-screening approval to your Alpha Nur host prior to your visit.

REF: AN-VIS-2026-——

Before Visit Date

Alpha Nur will review your submission and notify your Alpha Nur host. You will be contacted at the email address you provided once pre-screening is complete.

Allow up to 3 business days for review. If your visit is scheduled sooner and you have not received confirmation, contact your Alpha Nur host directly.

Date of Visit

Bring Your Registered ID: You must present the exact same government-issued ID you registered in this form — same document type and same document number. No substitute IDs will be accepted at check-in.

Dress Code: Wear long pants, shirts with sleeves (no tank tops or sleeveless tops), and closed-toe, closed-heel shoes. Shorts, skirts and dresses, sandals, and high heels are prohibited on site. All clothing must be made from nonsynthetic, natural fibers (e.g., cotton, wool, leather) and must allow for secure badge attachment.

Open Wounds & Skin Conditions: Visitors 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.

Choose how to share your ID

Wallet

Digital State ID, Driver's License, or Passport

Google Wallet

Digital State ID, Driver's License, or Passport

AZ MVD Now

Digital ID · State Provider

Alpha Nur, Inc.

Illinois Driver's License

Government-Issued ID

The following information will be shared with and stored by Alpha Nur, Inc.:

Legal Name

Issue Date

Date of Birth

Expiration Date

ID Number

Driving Privileges

State

Address

Age in Years

Issuing Authority

Sex

REAL ID Status

Alpha Nur, Inc. will use your information for secure facility access verification. Your data is processed in accordance with applicable federal law.

Face ID

→

Share this info with Alpha Nur, Inc.

Illinois Driver's License

ID-202-…

According to Alpha Nur, Inc.

The following info will be shared and stored:

Portrait

Given names

Family name

Date of birth

Document number

Expiry date

Issuing state

Resident address

REAL ID

The Google Privacy Policy describes how your data is being handled by Google Wallet. Look to Alpha Nur's Privacy Policy for information on how Alpha Nur, Inc. will handle the shared information.

Confirm your identity

Touch the fingerprint sensor to authorize sharing with Alpha Nur, Inc.

Face ID

Authorizing identity verification…