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Prime Contractor Sign-up Form

Supply Chain Visibility (SCV) Prime Contractor User Registration Form

* indicates a required field

*** Please enter your work email below to receive the registration confirmation. ***

Email*

Prime Contractor Name (as stated in the awarded NASA contract)*

Prime Contractor Registered Address (complete address as stated in the awarded NASA contract)*

Street Address City State / Province / Region ZIP / Postal Code Country

NASA contract number for the contract containing the DRD for SCV Reporting*

Identify if you are the primary or alternative individual designated by the prime contractor to perform the submission of the required SCV reporting. Make selection.*

Primary

Alternative

The designated primary and alternative individuals must separately complete and submit the form.

Designated Primary Individual

Last name of the primary individual*

First name of the primary individual*

Is the work email address of the primary individual the same as previously entered in the "Email" field at the top of this form?*

Yes

No

Please enter the work email address of the primary individual*

Country Citizenship of the primary individual*

Designated Alternative Individual

Last name of the alternative individual*

First name of the alternative individual*

Is the work email address of the alternative individual the same as previously entered in the "Email" field at the top of this form?*

Yes

No

Please enter the work email address of the alternative individual*

Country Citizenship of the alternative individual*

Name

This field is for validation purposes and should be left unchanged.