Full Legal First Name *

Full Legal Middle Name *

Full Legal Last Name *

Nick Name for Name Tag *

Position/Rank *

Email *

Phone *

Citizenship * U.S. Citizen Permanent Resident (Green Card) Dual Citizenship Foreign National

Do you have an active CAC, Military ID, Ret. Military ID, or other form of access to the installation? yes
no

Company/Organization *

Website URL *

Company Abstract * Please select action... Use New or Update Existing (Enter new text below) Use Existing

Company Abstract (250 words)

Technology Title *

Demonstrating Technology Type * Select ... Advanced / Additive Manufacturing Autonomic Logistics Business Processes and Partnerships Coatings and Corrosion Prevention Condition-Based Maintenance + Energy, Environmental, Health, and Safety Enhanced Inspection Reliability Improvement Training / Misc.

Technology Short Description * Please select action... Use New or Update Existing (Enter new text below) Use Existing Add additional technology to Company Page (Enter New Text Below)

Technology Short Description (250 words)

POC Name *

POC Email *

POC Telephone *

How long has this equipment been available for use?

What benefits will this technology bring to Carrier Maintenance? (Please explain)

How many other companies are currently using this product? (Please list)

Is there any security clearance level required in order to utilize this product?

If selected for the expo, what size area will accommodate your demo?

Will you bring pamphlets or any marketing information to pass out during the event?

Access to electricity needed for demonstration * No
Yes

If yes, which element(s) of demonstration requires electricity

I can hand carry all demonstration items * Yes
No

Special requests for display/demonstration (ie. compressed air, material, location)

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By completing this form, I agree to all statements found in NCMS Event Registration Guidelines and Event Disclosure and Confidentiality Agreement *