Family name (as in passport):
First name(s) (as in passport):
Affiliation:
Position:
Address (official)
Street address:
City:
Postal code:
Country:
Fax (official):
Phone (official):
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:
I intend to give a talk:
Title:
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:
Do likewise with the passports of all accompanying persons.
I would like to come with accompanying person(s):
IMPORTANT: Please, check that your medical insurance is valid in Russia.