+-----------------------------------------------------------------+---+
| Site Visit                                                      |   |
| & Pre-proposal Conference {#site-visit-pre-proposal-conference} |   |
| ====================================                            |   |
|                                                                 |   |
| Registration Form {#registration-form}                          |   |
| =================                                               |   |
|                                                                 |   |
| To attend the site visit or pre-proposal conference, please     |   |
| fill out this form and submit it by e-mail to                   |   |
|                                                                 |   |
| <BaghdadGSOProcurement@state.gov>                               |   |
|                                                                 |   |
| Solicitation Number: SIZ100-09-R-0120                           |   |
+=================================================================+===+
| Company name:                                                   |   |
+-----------------------------------------------------------------+---+
| Company street address:                                         |   |
+-----------------------------------------------------------------+---+
| Name (Last, First):                                             |   |
|                                                                 |   |
| Title:                                                          |   |
|                                                                 |   |
| ID Type and Number:                                             |   |
|                                                                 |   |
| Date of Birth:                                                  |   |
|                                                                 |   |
| Place of Birth:                                                 |   |
|                                                                 |   |
| Citizenship:                                                    |   |
|                                                                 |   |
| Telephone (including area code):                                |   |
|                                                                 |   |
| Fax (including area code):                                      |   |
|                                                                 |   |
| E-mail:                                                         |   |
+-----------------------------------------------------------------+---+
| Name (Last, First):                                             |   |
|                                                                 |   |
| Title:                                                          |   |
|                                                                 |   |
| ID Type and Number:                                             |   |
|                                                                 |   |
| Date of Birth:                                                  |   |
|                                                                 |   |
| Place of Birth:                                                 |   |
|                                                                 |   |
| Citizenship:                                                    |   |
|                                                                 |   |
| Telephone (including area code):                                |   |
|                                                                 |   |
| Fax (including area code):                                      |   |
|                                                                 |   |
| E-mail:                                                         |   |
+-----------------------------------------------------------------+---+
| Name (Last, First):                                             |   |
|                                                                 |   |
| Title:                                                          |   |
|                                                                 |   |
| ID Type and Number:                                             |   |
|                                                                 |   |
| Date of Birth:                                                  |   |
|                                                                 |   |
| Place of Birth:                                                 |   |
|                                                                 |   |
| Citizenship:                                                    |   |
|                                                                 |   |
| Telephone (including area code):                                |   |
|                                                                 |   |
| Fax (including area code):                                      |   |
|                                                                 |   |
| E-mail:                                                         |   |
+-----------------------------------------------------------------+---+
| (Note: Please add more line(s) by copy & paste the above line   |   |
| if necessary.)                                                  |   |
+-----------------------------------------------------------------+---+