Arithmetic Geometry
June, 2000

Registration Form

Family name:

First name(s):

Affiliation (Institute name and address):

Position:

Fax:

Phone(s):

e-mail:

I need a hotel:

yes no

From:

Till:

Please, give the details about the type of room you wish and
the persons you wish to share the room with :
number of rooms:
shared with:
price per appartment:
number of persons:

I intend to give a talk:

yes no

   

Title:

   
   

I need a Russian visa:

yes no
   

If you need a visa, please, fill in the following VISA FORM:
   

Date of arrival:

Date of departure:

Citizenship:

Passport number:

Passport expiration date:

City (with a Russian Consulate) where you will apply for a visa:

Date of birth:

Place of birth:

FAX number to send the invitation to:
Mailing address to send the invitation to:
   
IMPORTANT: you need to send a copy of your passport
(as usual, this means "a copy of two adjacent pages one
of which contains your photo") by fax to

 7 812 234 58 19 for Elena Novikova

Do likewise with the passports of all accompanying persons.

   

I would like to come with accompanying person(s):

yes no

   
If "yes", please, make a separate registration and visa form for each accompanying person: fill in the same fields for everyone (DO NOT omit affiliation, position, address and fax of the institution FOR EMPLOYED and FOR STUDENTS or PUPILS).
   

 

Fill in the above APPLICATION FORM or send via E-Mail or FAX to:

FAX: +7 812 234 5819

E-mail: novikova@pdmi.ras.ru