International Summer School and Workshop on

Hot points in Astrophysics and Cosmology


REGISTRATION FORM

 

        Last name:

        First name:

        Middle nam(es):                  The names should be typed exactly as in your passport.

                                                                             No abbreviations are valid. This is important for visa application.

        Title (Prof/Dr/Mr/Mrs):

        Sex:   Male  / Female 

        Institution: 

        Position in home institute:

        Mailing address:

                                 

        Phone (office): 

        Fax (office):

        E-mail:

        I need an entry visa:         - if yes, please, fill in additionaly

PERSONAL DATA FOR VISA:

        Birthdate:

        Citizenship: 

        Passport number:

        Passport valid until:

        In which town do you intend to apply for Russian visa?

        Itinerary inside Russia:

        Preliminary arrival date:

        Preliminary departure date:

PLEASE, CHECK YOUR DATA BEFORE SUBMITTING.
BE SURE YOUR E-MAIL IS TYPED CORRECTLY.


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