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| Experiment Name* | *Required Field! Brief Experiment Name (50 Character Maximum) |
| Event Number* | *Required Field!
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| Company Name* | *Required Field!
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| CAGE Code* | *Required Field!
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| DUNS Number* | *Required Field!
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| Are you a Small Business? |
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| Principle Investigator/PI* | *Required Field! (whom all the info will go to) |
| PI Telephone Number* | *Required Field!
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| PI Email Address* | *Required Field!
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| USSOCOM/SOF POC (If Applicable) |
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| USSOCOM/SOF POC Telephone Number (If Applicable) |
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| USSOCOM/SOF POC Email Address (If Applicable) |
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| Capability Areas of Interest* | *Required Field! Select/Highlight One |
| Technology Readiness Level* | *Required Field! Select/Highlight One |
| Technology | Provide a Brief Description of your Technology: What it is and What it does? |
| Experiment Objectives* | *Required Field! What is it you intend to prove? |
| Experiment Plan* | *Required Field! How do you plan on conducting your demonstration?
- Measurement/Data Collection Plan: |
| Performance* | *Required Field! Measures of Performance/Measures of Effectiveness: |
| New Capability* | *Required Field! What new capability (or improvement to existing capability) does this represent to the war fighter? This is the "So What?" |
| Capability Gap* | *Required Field! Which (if any) existing gap does this capability address? |
| Inside and/or Outside Space* | *Required Field! Please specify if there are limiting environmental factors |
| Unmanned Aerial Systems/UAS* | *Required Field! Will you be bringing a UAS?
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| --UAS Type | If you are bringing a UAS, which kind and how many? |
| Live Fire* | *Required Field! Does your experiment include live fire/kinetic/energetic operations? All respondents wishing to conduct experiments of a kinetic or energetic nature are responsible for ammunition and/or explosive shipments to include and Interim Hazard Classification (IHC) or final Hazard Classification (FHC) and coordination for receipt and storage at each venue. |
| --Live Fire Type | If you wish to conduct a live fire type experiment, what caliber and quantity of rounds or type/quantity of explosives? |
| Laser* | *Required Field! Does your experiment involve the use of lasers, to include eye-safe lasers? |
| --Laser Class | If yes to using a laser, what class? |
| --Laser Wavelength | If yes to using a laser, what laser wavelength in nanometers? |
| Vehicles* | *Required Field! Does your experiment require vehicles, ATVs, trucks, etc. as part of the actual experiment? |
| --Vehicle Use | If yes to using vehicles, what types of vehicles and how will they be used? |
| Safety | Other Potential Safety Issues, e.g. Explosives, pyrotechnics, hazardous chemical substances, or other occupational hazards |
| Responsibilities | Participant Names/Responsibilities |
| Experiment Duration | Time required to complete experiment (hrs - min and max, pretest required?) |
| Night Operations* | *Required Field! Does your experiment require operating during the hours of darkness? All efforts will be made to accomodate, however resources for night operations are limited. |
| Communication Frequency* | *Required Field! Will you require Frequency Utilization?
If your experiment will be radiating on a given frequency or frequency band, you must have prior approval to transmit on that frequency. Prior approval may include compliance with Federal Communications Commission (FCC) Title 47, Part 15 or a Special Temporary Authority (STA) from the FCC. If equipment is government owned and operating within a Federal Band, you must have National Telecommunications and Information Administration (NTIA) frequency approval. Your authority to radiate should be submitted along with your nomination or emailed directly to tech_exp@socom.mil. The FCC recommends you submit you request at least 30 days prior to the start of the event. |
| --Antenna Type |
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| --Frequencies | What Frequencies are required? |
| --Frequency Band | Frequencies Band |
| --Power Transmitted | Power Transmitted (Specify watts or dBm) |
| Size* | *Required Field! What are the physical dimensions of your technology solution? Please specify units. If this is not applicable, please type N/A above. |
| Weight* | *Required Field! What is the weight of your technology solution? Please specify units. If this is not applicable, please type N/A above. |
| Power* | *Required Field! What are the power requirerments of your technology solution? Please specify units. If this is not applicable, please type N/A above. |
| Remote Site* | *Required Field! If a remote site is needed (e.g., experiment cannot take place at TOC), what support is required? |
| Remote Power* | *Required Field! If a remote site is required, will you require power (based upon availability) and what are your power requirements (i.e. current and voltage [120V or 240V])? |
| Publish* | *Required Field! Do you anticipate publishing the results of your tests? Any published information may require prior SOCOM Public Affairs approval. |
| --Publish Location | If Yes, which publication? |
| International Traffic in Arms (ITAR) or Export Administration Regulations (EAR) Restrictions* | *Required Field! Does your technology have any ITAR or EAR restrictions? |
| Terms and Conditions Agreement* | *Required Field! "I have read and agree to the Technical Experimentation Terms and Conditions." |
| Attachments | Add Current Attachment to list If adding attachments, remember to browse for the file and click "Add Attachment" above. |
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