MERRILL Guest Request Form – GUEST PORTION | MERRILL | Design. Fabricate. Machine. Integrate.

As a valued MERRILL guest it is imperative that you complete the remainder of this form in its entirety. Upon completion simply click SUBMIT. Enjoy your visit! Please note, you must present a U.S. Government and/or State-issued photo ID upon check-in.

Guest First Name*

Guest Last Name*

Guest Phone*

Guest Email*

Date(s) of Visit*

Entrance Badge Location (where you will initially meet)*

(Visiting? Y/N) 400 Florence St. Saginaw, MI 48602*

(Visiting? Y/N) 1023 S Wheeler St, Saginaw, MI 48602*

(Visiting? Y/N) 21659 W. Gratiot Rd., Merrill, MI 48637*

(Visiting? Y/N) 520 Republic Ave., Alma, MI 48801*

(Visiting? Y/N) 2000 S. Hamilton St., Saginaw, MI 48602*

(Visiting? Y/N) 1375 S. 25th St., Saginaw, MI , 48601*

Host First Name*

Host Last Name*

Host Email*

I am a (Choose only ONE):*

U.S. Citizen (Via birthright or naturalization)
Permanent U.S. Resident (Green Card Holder)
Non-U.S. Person (Anyone who is not a U.S. citizen, a lawful permanent resident or protected individual)
U.S. citizen who represents a foreign government
U.S. citizen who represents a foreign company
U.S. citizen who represents a foreign organization that is not incorporated in the U.S.
U.S. citizen who represents an international organization (NATO, UN, etc.)

I am a Returning Visitor*

Yes
No

Residential Address*

City State / Province / Region Country

I am a U.S. Government Employee:*

Yes
No

Name of Company*

Name of Governmental Agency*

Driver's License Number*

Issuing State*

Foreign Persons / Foreign Nationals Only.
Original Passport required at Entry:

Passport Number*

Birth Date*

Expiration Date*

Issuing Country*

Citizenship Country*

I Agree to the MERRILL's Group Safety Rules: (See Below)*

Yes
No

Download MERRILL's Group Safety Rules

I Agree to the MERRILL's Non-Disclosure Agreement: (See Below)*

Yes
No

Download MERRILL's Non-Disclosure Agreement

Upon completing this form, I understand that any device with the ability to take photos and/or videos is prohibited from the shop floor of all MERRILL facilities. These devices are allowed in designated office/meeting space only. Check with your MERRILL host for clarification on usage. This does not apply to U.S. Government employees.

Visitor Approval*

Today's Date (Information provided is valid one year from today's date*