Euler IMI

Algebraic Geometry, K-theory, and Motives

(a conference dedicated to Andrei Suslin's 60th birthday)

St. Petersburg, Russia
June 25-29, 2010

Visa Form

Family name:

First name(s) as in passport:


male      female


I need a Russian visa:

business tourist

Date of arrival:

Date of departure:


Country of permanent residence:

Passport number:

Passport issue date:

Passport expiration date:

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

Date of birth:

Place of birth:

FAX number to send the invitation to:
Mailing address to send the invitation to:

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).
I would like to visit cities:

IMPORTANT: you need to send a copy of your passport
(as usual, this means "a copy of two adjacent pages one
of which contains your photo") preferably as a scanned image by e-mail to

Do likewise with the passports of all accompanying persons.

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

Fill in the above APPLICATION FORM and press the SUBMIT button