FRIB-S10200-FM-000166-R002
Non-Public Tour Certification Form
Participants in Facility for Rare Isotope Beams (FRIB) and National Superconducting
Cyclotron Laboratory (NSCL) Tours
FRIB/NSCL and its visitors are obligated to follow federal regulations concerning safety and Export
Control (15 CFR Chapter VII Subchapter C part 730-780 and 22 CFR part 120-130).
FRIB and NSCL contain some areas that are restricted for safety reasons. We are obligated to
instruct visitors about potential safety hazards and such things as limits on radiation exposure.
However, it is expected that there will be no undue hazards or risks present where visitors are
allowed access.
I have made the members of the party aware that certain technology and information within
FRIB/NSCL is subject to federal Export Control restrictions.
I certify that the _______ (#) members of the party participating in the FRIB/NSCL tour held at
Michigan State University on ___________________ (date) are all:
i. personally known to me, and
ii. not a citizen/resident of Cuba, Iran, North Korea, Sudan or Syria
(Signature)
(Printed Name)
(Title)
(Email – optional)
(Date)