Calculations for Modern and Future Colliders. Registration Form.

5^th Helmholtz International Summer School - Workshop
Dubna International Advanced School of Theoretical Physics - DIAS TH
Calculations for Modern and Future Colliders
July 23 - August 2, 2012, Dubna, Russia

Main Page

General Information

Registration Form

List of Participants

Talks

Programme

Sponsors

Travel Information

Contacts

Supported by :

REGISTRATION FORM

Please, fill in the following form with latin letters. Fields, marked with an asterisk ^*sign, are obligatory. After submitting your information you will get e-mail confirmation of your registration.

Title:
Surname:^*
First Name:^*
Second Name:^*
Passport number:^*
Institution:^*
Position:
Mailing address:
Postal code:
City:^*
Country:^*
Phone (office):
Fax:
E-mail:^*
I plan to contribute a talk:^*	yes no
Contribution title

Visa information

Non-residents who need Russian visa should supply their personal data as well.

To arrange a visa support letter, you are kindly requested to send a scanned COPY OF YOUR PASSPORT (the main page with a photo) to Olga Matyukhina by e-mail omatyukhina@jinr.ru or by fax +7 (49621) 65891.

In case one applies for the visa not in one's native country, a copy of a resident permit should also be sent. All fields are obligatory.

The same application form should be filled for accompanying persons.

Date of birth:
Place of birth:
Passport number:
Passport date of issue:
Passport valid until:
Citizenship:
Sex:	male female
Place of applying for the visa:
(Exact city of the Russian Consulate or Embassy in your country)
Itinerary inside Russia:
Preliminary arrival date:
Preliminary departure date:

Bogoliubov Laboratory of Theoretical Physics