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Technical Tour Form
Please check the tour(s) that you will be taking:

[28]
Armed Forces Radiobiology Research Institute (AFRRI) - Thursday, November 19, 2009, 12:00pm - 5:00pm)
Please note that you must be registered for the 2007 ANS/ENS International Meeting to participate in the Trinity Site technical tour.  No exceptions!

 First Name and Middle Initial

 Last Name

 Daytime Phone

 Fax

 Email

 Do you have any special needs that must be accommodated for you to participate fully in the
 tour(s)? If so, please specify.


 Social Security Number

 Date of Birth

 Age

 Gender

 Employer's Name

 Employer's Address   (Address; City; State; Zip)
Non-U.S. Citizens Please Complete the Following

 Full Name (as stated on passport)
U.S. Permanent Resident:
Yes
No
If you do not have permanent resident status, please continue to answer the following:

 Date of Birth

 Place of Birth (city and country)

 Passport Number

 Expiration Date

 Passport Issuing Country

 Citizenship

 Countries of Dual Citizenship (if applicable)

 Country of Residence

 Title/Position

 Gender

 Organization Name and Address

 Organization Telephone Number
Note to all: you will be required to present your photo identification (passport or green card for non-US citizens; driver's license for US citizens) before the start of the tour.  Tour attendance by non-US citizens may be restricted by the host organizations.  No recording devices (cameras [to including cell phone cameras], etc.) are allowed within the secure areas of the facilities.

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