Safeguards & Security Evaluations Account Request Form

To obtain a user id and password to access the Safeguards & Security Evaluations, Please complete all required fields indicated by an asterisk. We will provide a username and password to new account holders. Please allow several business days to process your account request. When your request is approved, you will be contacted with your account information.

* = Required Field
*First Name:
*Last Name:
*Address 1:
Address 2:
*City:
*State:
*Zip:
*Organization:
*Phone:
Fax:
*E-mail:
*ORPS/CAIRS Account Holder?: Yes No
If Yes, ORPS/CAIRS Username:
*DOE Contact:
*DOE Contact Phone:
*Justification:

This page was last updated on July 29, 2008

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