Dover Air Force Base Civilian Pass Request Form

To be completed by students who do NOT have access to DAFB.

Civilian students attending Southern Illinois University at Dover Air Force Base must supply the following information at the time of registration and prior to class weekends at Dover AFB.  Dover AFB Security Police will conduct a background check for each civilian before granting access to the base.  Once the background check has been completed, an approved Student Pass can be picked up at the Dover Air Force Base Main Gate.  Passes must be picked up prior to the class meeting time.  On the weekends, please arrive 30 minutes prior to class to obtain your pass on the first weekend.  The pass is valid only for the days and times listed for the length of your current registration.  The Student Pass must be presented at the Main Gate each class meeting time to gain access to the Education Center.  The Student Pass must remain in the vehicle and be displayed on the dashboard while on Dover AFB.  Please secure the Student Pass in a safe place in your vehicle while not on Dover AFB.  Civilian students must report directly to Building 639 for classes and are not permitted to travel anywhere else on Dover AFB.  Violation of the pass restrictions will result in permanent removal from Dover AFB.

Please complete the following information and fax to

Southern Illinois University DAFB office at (302) 734-2092.

LAST NAME                                                        FIRST NAME                                                       M.I.

DATE OF BIRTH                                                   SS#

DRIVER’S LICENSE #                                         STATE OF ISSUE                                EXPIRATION DATE

CURRENT ADDRESS

HOME PHONE #                                                WORK PHONE #

CIRCLE ONE:                        SPRING                                  SUMMER                              FALL