1Your information

Fields marked * are required.

Full name *

Email *

Credentials / relevant background *

Preferred contact (phone, email, Signal…)

Availability

Role *

SME validation panelist Board of SATCOM Advisors member Other

Credential / project *

Tactical SATCOM Specialist (TSS) Other

2Consent & permissions

I confirm the following:

I agree to participate as a subject-matter expert on ATG's TSS certification validation panel. * I understand my ratings, comments, and deliberations are confidential and become ATG's protected intellectual property, and that I gain no ownership interest in the credential. * I grant ATG permission to record my name and credentials in the confidential ISO/IEC 17024 validation documentation, disclosed only to the DoD and organizations that require such verification, and not made public. * I will contribute only unclassified information and will honor all obligations I owe the U.S. Government and any prior or current employer. *

OPTIONAL I consent to be listed publicly on the Board of SATCOM Advisors with the title below.

3Disclosures

For each item, choose No or Yes. For every Yes, describe the interest in the box that appears.

4Ongoing duty & how ATG manages conflicts

I will promptly disclose any new or changed conflict while I'm involved. * I understand ATG may manage a disclosed conflict to protect the credential — for example, by asking me to recuse from a specific item or decision — and that doing so does not reflect on my integrity. *

5Attestation

I attest that the information above is accurate and complete to the best of my knowledge, that I will validate or advise impartially, and that I will notify ATG if anything changes. *

Signature — type your full name *

Date *

I agree that typing my name above is my electronic signature and has the same effect as a handwritten signature. *

Conflict of Interest Disclosure & Attestation

1Your information

2Consent & permissions

3Disclosures

4Ongoing duty & how ATG manages conflicts

5Attestation

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