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Registration Form
6-th International School for Young Scientists
"WAVES AND VORTICES IN COMPLEX FLUIDS"
Kaliningrad, June 21 – 23, 2015
Please fill in ALL the gaps in the form (in English) to avoid any misunderstanding.
Please fill in the FORMs for the accompanying persons too.
Firstname:
Father’s name:
Home address:
Postal or Zip code:
Date of birth:
Gender:
Passport number:
Date of issue:
Participant / Accompanying person:
Lastname:
male / female
Country:
Place of birth:
Nationality:
Expiry date:
Occupation (full appellation of organization):
Full address of organization:
Postal or Zip code:
Position:
Tel.:
Arrival date:
Country:
e-mail:
Fax:
Departure date:
Location of Russian consulate where you plan to get your visa:
Route in Russia for pre- and post-conference period:
Please submit this form to:
Professor Yuli D. Chashechkin
A.Yu. Ishlinsky Institute for Problems in Mechanics of the RAS
101(1) Vernadskogo Ave., Moscow, 119526, Russia.
Fax: +7-499-739-9531;
Tel.: +7-495-434-0192
E-mail: [email protected] , [email protected]
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