NAME

SURNAME

INSTITUTION

ADDRESS

CITY

COUNTRY

PHONE

FAX

E-MAIL

R$ 400,00 for members
R$ 450,00 for non-members

Payment can be made:

• Either by Bank transfer in R$ to account “Seção Latino Americana – ANS” n.º 120847.0, Banco do Brasil, Agency 0287 – 9, Rio de Janeiro;

• Or by mail to:

Mr. João Furley
SECRETARY LAS/ANS c/o IBQN,
Av.: GENERAL JUSTO, 365
Rio de Janeiro – Brazil  CEP: 20021 -130

• Or check in US$ to the order of  “Latin American Section of ANS”.

Do you present a paper? YES NO

Would you like to technical visit Angra NPP on June 25? YES NO