Section 1: Requestor Information

Requestor Name Title/Rank: Address: Phone Email

Section 2: Purpose of Request

TestingEvaluating Demonstration

Non-Disclosure Requirements

DISA will not require a non‐disclosure agreement from DISAWERX participants for most DISAWERX activities. However, in some cases, specific DISAWERX Innovation Projects may require a non‐disclosure agreement. DISAWERX participants can make individual decisions as to whether they are comfortable signing a non‐disclosure agreement in such cases. DISA government personnel will not sign individual corporate non‐disclosure agreements but will follow federal non‐disclosure rules.

Description

Describe the product you will test or demonstrate with specific details of what the test of demo is supposed to achieve. Attach all relevant diagrams, documents, or references to include any product documentation (i.e. capability documents) describing configuration, installation, operation, and maintenance required of administrators. If you are testing a software/application or utility, fill out “Application/Software” section accordingly. If you are demonstrating, specify the names of the demo attendees. Explain why you feel the DISAWERX Innovation Center is best suited to your needs.

Description:

Application/Software

Provide information and details on the application / code and its functionality:

Name of Application/Code: Function: Version:

Is any "Open Source" code used on the application?

Is any "Open Source" code used on the application? Yes No Developers information

Network Requirements

Describe address space requirements, bandwidth, etc.

Software

Describe software or operating systems that may be required, as well as licensing, etc.

Hardware

Describe the following requirements:

1. How much RAM do you intend to use for your virtual machines? 2. How much hard drive space do you intend to use? 3. What operating system do you intend to use? 4. Will you bring your own operating system image, or will you use our standard Windows 10 Enterprise operating systems Disk image? 5. How much network bandwidth do you need?

External System Communication Requirements

List the components that require communication with any external system. Please specify the source and target IP addresses, ports and protocols used by each.

External System Name and Domain Function Incoming/Outgoing Ports Protocols Target IP Address List any additional components requiring communication with any external system as above.

Other Information

List any additional services required from the DISAWERX personnel.

Additional Hardware

Will additional hardware be brought to DISAWERX? Yes No If yes, list the item(s), with barcode / serial #, and dimensions (if floor space is required)

Proposed Timeline

Provide a timeline for the product testing / demonstration to include proposed start and completion dates and any significant milestones. If you are using the DISAWERX Innovation Center for a demo, you must specify a date for a rehearsal at least one week in advance of the actual demo date. Include the date that necessary equipment will be delivered to the DISAWERX Innovation Center.

List dates, Milestones and Descriptions for each.