Joint Institute For Nuclear Research
INTERNATIONAL SYMPOSIUM
Dubna
, July 2-5, 1997
Registration form
Please fill registration form below or send the
plain version
to
Mrs. V. K. Novikova
.
PARTICIPANT
Surname:
First Name:
Second Name:
Institution:
Position:
Mailing address:
Postal code:
City:
Country:
Phone (office):
FAX:
E-mail:
I plan to contribute a paper:
Yes
No
Contribution title:
The dead-line of annotation is June 15 !
ACCOMPANYING PERSON(S) (under 16)
Name(s):
INFORMATION FOR THE VISA
Birthdate:
Citizenship:
Sex:
Passport number:
Passport valid until:
Town you intend to get your visa in russian consulate:
Itinerary inside Russia:
Preliminary arrival date:
Preliminary departure date:
Last modified: Apr 9, 1997
Copyright 1997
Serge G. Bondarenko
,
Alexander Molochkov