Registration Form

Please submit the registration form before 01 JUNE 2004 for participation the conference.

PERSONAL DATA
* Last/Family name
* First/Given and Middle names
* Gender:
* Nationality:
* Title:
* Position:
AFFILIATION
* Affilation:
* Mailing address (including Zip code):
* Phone ( e.g. +81-11-706-2678 ):
FAX:
* E-Mail:
PERSONAL DATA FOR INVITATION LETTER FOR VISA APPLICATION
Please fill in positions in this section only if you need in visa:
Date of birth (dd/mm/yyyy):
Place of birth:
Home address:
Home phone:
Travel information:
Planned dates of arrival to Russia:
Planned dates of departure from Russia:
List of Russian cities (except for Nizhny Novgorod) which you plan to visit (not more than 5 cities):
The place where you will apply for visa (city, country):
DATA CONCERNING YOUR TALK
*Do you plan to present a talk?	YES NO
The title of your talk:
Do you need for your talk
Overhead?	YES
MP3-projector?	YES
Any other special tools?
ACCOMMODATION
Do you need an official invitation letter?	YES NO
Planned dates of arrival to Nizhny Novgorod:
Planned dates of departure from Nizhny Novgorod:
Do your need hotel reservation?	YES NO
Do you have any special needs?
Name of accompaning person(s):
Submit please the same form for every accompaning person.