WAVELETS AND SPLINES

July 3-8, 2003, Saint Petersburg, Russia

Registration Form

Family name:

First name(s) (as in passport):

Citizenship:

Country of permanent residence:

Degree, title(s):

Affiliation:

Position:

e-mail:

Phone(s):

Fax:

   

I want to present a talk (lecture)

yes no

I want to present a poster

yes no

Title:

Session:

My presentation is joint with the following participants:
Do not set my talk to [date(s)]:
   

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

yes no

Their names:


If you need a visa fill in the following fields:

I intend to visit Russia from

to

Mailing address (office):

Mailing address (home):

Date of birth:

Place of birth:

Passport number:

Passport date of issue:

Passport date of expiry:

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

FAX number to send the invitation to:
Mailing address to send the invitation to:
I would like to visit the cities:
   
If you come with accompanying persons , please, fill in the same fields for each of them. (DO NOT omit affiliation, position, address and fax of the institution FOR EMPLOYED and FOR STUDENTS or PUPILS).

IMPORTANT: you need to send a copy of your passport (this means "a copy of two adjacent pages which contain your photo, passport number and passport expiration date") to FAX: 7 (812) 234 58 19 for Elena Novikova

Do likewise with the passports of all accompanying persons.

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

 

Conference e-mail: ws@imi.ras.ru