REGISTRATION FORM PARTICIPANT SURNAME (Prof/Dr/Mr/Mrs)........................................... FIRST NAME......................................................... SECOND NAME........................................................ INSTITUTION........................................................ POSITION........................................................... MAILING ADDRESS.................................................... POSTAL CODE........................................................ CITY............................................................... TEL(office)........................................................ FAX................................................................ E-mail............................................................. I plan to contribute a paper:(yes/no).............................. Contribution title................................................. ................................................................... 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......................................... ----------------------------------------------------------------------------- -----------------------------------------------------------------------------