International Workshop
"HEAVY QUARK PHYSICS"

REGISTRATION FORM

Participant

First Name:
Surname:
Second Name:
Institution:
Position:
Mailing address:
Phone (office):
FAX:
E-mail:

I plan to contribute a paper:
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)

Name(s):

Please, send a copy of your passport by fax or ordinary mail to organizers. Please, find the address here.

Last modified: Nov 11, 1997
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