21st Days of Weak Arithmetics

Registration Form



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:
number of rooms:
shared with:
price per apartment:
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:

FAX number to send the invitation to:
Mailing address to send the invitation to:
   
IMPORTANT:You should send a copy of your passport (the pages containing your name, passport number and passport expiration date). It is preferable to scan your passport and send the image as attachment by email to Elena Novikova novikova@pdmi.ras.ru or send a copy by fax to

7 812 234 5819 or 7 812 310 5377 for Elena Novikova.

Do likewise with the passports of all accompanying persons.

   

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

yes no

Their names:

   
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).

IMPORTANT: Please, check that your medical insurance is valid in Russia.

   


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