PRE-REGISTRATION FORM

I plan to attend the XVIIIth International Workshop in St. Petersburg (Russia), 17-23 June 2004.

Family Name:
First Name:
Sex:	Male Female
Position (title):
Organization:
Mailling Address:
City:
Code:
Country:
Phone:
Fax:
E-mail:
Accompanyning Person:	Yes No
I would like to present a report tentatively entitled:
Abstract: (Definite title and abstract should be submitted before May 1, 2004)
The Organizing Committee would like to remind you that entry visa must be obtained before entering Russia. To provide us with the information, which is necessary for processing your visa, please send us by e-mail a scanned copy of your passport in JPG format or by fax, and complete the lines below:
Date of Birth:
Place of Birth (town, country):
Citizenship:
Home country:
Passport Number:
Dates of Issue and Expiration:
Location of the Russian Consulate to which you will apply for visa (town, country):
Arrival date:
Departure date: