******************* REGISTRATION FORM and VISA INFORMATION ******************* The Vth International Workshop "HEAVY QUARK PHYSICS" April 6-8, 2000, JINR (Dubna, Russia) REGISTRATION FORM Full Name: ........................................................... Institution: ......................................................... Position: ............................................................ Mailing address: ..................................................... Phone (office): ...................................................... FAX: ................................................................. E-mail: .............................................................. I plan to contribute a paper: Yes / No Contribution title: .................................................. INFORMATION FOR THE VISA Birthdate: ......................................................................... Citizenship: ....................................................................... Sex: ............................................................................... Passport number: .................................................................... Passport valid until: ............................................................... In wich town do you intend to get your visa to entry Russia: .................... Itinerary inside Russia: ........................................................... Preliminary arrival date: .......................................................... Preliminary departure date: ......................................................... Accompanying Person(s)(under 18) .................................................... Note: Please, send a copy of your passport by fax or ordinary mail to organizers, find the address below. Send this registration form, by fax, e-mail or ordinary mail to: Prof. M.A.Ivanov Bogoliubov Laboratory of Theoretical Physics Joint Institute for Nuclear Research 141980 Dubna (Moscow region) Russia Email: hqp2000@thsun1.jinr.ru FAX: 7-09621-65084 Dr. E.Z. Lipartia (Scientific secretary) Bogoliubov Laboratory of Theoretical Physics Joint Institute for Nuclear Research 141980 Dubna (Moscow region) Russia Email: hqp2000@thsun1.jinr.ru FAX: 7-09621-65084