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First Name*:

Last Name*:

Middle Initial:

Work Fax:

Email Address*:

Work Phone*:

Job Title*:

Company name*:

Work Address*:

City*:

US Citizenship*:

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Check box that applies*:

New UserUpdate User (Modifications to organization or personal contact information)

CAIRS Access*:

Read Access OnlyDirect Data Entry (Training Required)

Manager*:

Manager Title*:

Manager Phone*:

Manager Email*:

Computer Security: Indicate by your signature on the line below that you have read, understand, and will comply with the following:

I understand that using DOE computer systems, products, services, or equipment for personal use constitutes misuse/non-official use of Government property.
I understand that all computer files are subject to review for the purpose of ensuring Official Use Only of Government property.
I understand that I am responsible for protecting my assigned password for confidentiality. Sharing my password with anyone else is a security infraction and may result in my system access being revoked.
I understand that there is a potential for Unclassified Sensitive and Privacy Act information being contained in the computer system and that such information must be protected from unauthorized access and disclosure as required by DOE Order.
I understand that information obtained from CAIRS may contain Unclassified Controlled Nuclear Information (UCNI). Access to UCNI requires a "need to know" per DOE Order.
I understand that users failing to comply with the computer security policies described herein may be subject to disciplinary action.

Electronic Signature*:

Organization Name(s) for which you have CAIRS data entry authority.	Organization Code	Sub-Organization Code	A - Add D- Delete

EHSS Support Helpline 301-903-8358 | 1-800-473-4375 | EHSSUserSupport@Hq.Doe.Gov

Learn about the Department of Energy's Vulnerability Disclosure Program