Russian summer school-seminar - Modern theoretical problems of gravitation and cosmology

September 9-16, 2007, TSHPU, Kazan-Yalchik, Russia

Registration form of the participant:

Family name:
First name:
Institution:
Position:
Exact post address:
Phone:
Fax:
E-mail:
Accompanying persons:
Date of arrival and departure:
I need a single (double, place in double) room in the hotel:
Preliminary title and subject area of talk(s):

Information for getting a VISA (for accompanying persons also):

Full name (as in passport):
Date and place of birth:
Citizenship:
Passport number:
Date of issue:
Date of expiry:
Affiliation (full name), its official address, phone, fax, and your official position there:
Purpose of visit (please, add "chlen sem'i" for the accompanying persons):
The route of travel (mention any other destinations you would like to visit in Russia, to be listed in your visa):
The nearest to you Russian Consulate for getting visa:

A faxed copy (or scanned and e-mailed) of your passport page with photo is also required.



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