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T AGENCY OR INDUSTRIAL FACILITY NAME: Email: POSTAL ADDRESS: TELEX/FAX NO: TEL NO: 3. GOVERNMENT AGENCY OR INDUSTRIAL FACILITY TO BE VISITED NAME: Email: ADDRESS: TELEX/FAX NO: POINT OF CONTACT TEL NO: If more than one site is to be visited please use the continuation sheet (Annex 2) 4. DATES OF VISIT: / / TO / / ( / / TO / / 5. TYPES OF VISIT (SELECT ONE FROM EACH COLUMN): GOVERNMENT INITIATIVE COMMERCIAL INITIATIVE INITIATED BY REQUESTING AGENCY OR FACIL.

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