University of Hawai’i
Office of Export Controls
Export Controls Visitor Screening Form
Instructions:
This form is required for visitors (non-UH/RCUH employees or students) to access export-controlled areas of the
University of Hawai`i (UH). Complete this form and send to the UH Office of Export Controls (UH OEC)
(http://www.hawaii.edu/offices/export/) well in advance of a planned visit, so a determination can be made
regarding export control compliance requirements prior to the visit. Do not allow the visit to take place until after
the UH OEC makes a determination and contacts you with instructions. For questions concerning export control
regulations, contact the UH OEC and refer to specific instructions in the Export Control Program Guidelines at
http://www.hawaii.edu/offices/export/guidelines.pdf.
Required information about visitor (one per form):
Name
Organization
Country of Birth
Date of Birth
Country of Citizenship
Required information about the visit:
Date of Visit
Purpose of the Visit
Name of the Host
Locations of the Visit (campus,
building, room numbers, etc.)
UH Project-Specific Technology Control
Plan (PSTCP) Number or Site Specific
Technology Control Plan (SSTCP)
Number
Submitted by: ________________________ (name of faculty/staff member who is hosting visit)
Date: _________________