ENVIRONMENTAL REPORTING LOGISTICS SYSTEM (ERLS)
    GREEN PROCUREMENT REPORT (GPR) REGISTRATION FORM  
  U.S. GOVERNMENT EMPLOYEE

Instruction for completing this form

Please return this form to DLIS-VSM (ERLS Access), 74 Washington Ave N STE 7, Battle Creek MI 49017-3084. FAX: Commercial (269) 961-5925 or DSN 661-5925.

PLEASE TYPE OR PRINT CLEARLY.

This is a Department of Defense (DoD) computer system. DOD computer systems are provided for the processing of official U.S. Government information only. All data contained on DoD computer systems is owned by the Department of Defense, may be monitored, intercepted, recorded, read, copied, or captured in any manner and disclosed in any manner, by authorized personnel. There is no right to privacy in this system. System personnel may give to law enforcement officials any potential evidence of crime found on DoD computer systems. Use of this system by any user, authorized or unauthorized, constitutes consent to this monitoring, interception, recording, reading, copying, or capturing and disclosure.

Block 1. Agency Information - Please provide information on the branch of the Government where you are presently working.

U.S. Government Branch of Service or Agency:__________________
(Such as Army, Navy, Air Force, DLA, etc.)

Major Command:___________________________________________
(Such as Army Materiel Command, Defense Reutilization and Marketing Service, etc.)

Activity Name:_____________________________________________
(Such as DRMO Lewis, DSCR, DDNV, etc.)

Installation Name:___________________________________________
(For example, Fort Lewis, Wright-Patterson AFB, DSCP, etc.)

Office Symbol, Code, Mail Stop:________________________________

Street/PO Box:______________________________________________

City/State/Zip Code:__________________________________________

City/Country (if APO or FPO Address)___________________________

Commercial Phone:________________DSN:_____________________

E-Mail Address:_____________________________________________

FAX:______________________________________________________

Block 2. ERLS User Information.

As a user of ERLS, I acknowledge my responsibility to conform to the following requirements and conditions as established by DLA:

I understand the need to protect my password. I will NOT share my password and/or account.

I understand that I am responsible for all actions taken under my account. I will NOT attempt to ‘hack" the network or any connected information system or network, or attempt to gain access to data for which I am not specifically authorized.

I acknowledge my responsibility to comply with all copyright laws both federal and state (where applicable).

I understand my use of DLA information systems is subject to monitoring to ensure proper functioning, to protect against improper or unauthorized use or access, and to verify the presence or performance of applicable security features or procedures. By using the information system I consent to such monitoring.

I acknowledge my responsibility to conform to the requirements stated above when using DLA information systems or networks. I also acknowledge that failure to comply with these requirements and conditions may constitute a security violation resulting in denial of access to DLA information systems, networks or facilities and that such violations will be reported to appropriate authorities for further action as deemed appropriate.

I understand the need to protect my password. I will NOT share my password/and /or user ID. If I no longer need access to ERLS, it is my responsibility to notify DLIS.

USER SIGNATURE___________________________DATE:______________

Printed Name:______________________________________________

Social Security Number (last six (6) digits only:______________________________________

DLA Standard LOGON:______________________________________

Email:_____________________________________________________

Commercial Phone:________________________DSN:_______________

Personal Identification Information – (This may be your favorite color, sports team, hobby or phrase.)

(1)________________________________________________________

Block 3. Supervisory Approval

This block must be completed by your supervisor.

Signature of Approving Official:_______________________________

Printed Name:______________________________________________

Title:______________________________________________________