A. N. Tyurin (1940–2002)

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Registration form
Participants

Russian Academy of Sciences Steklov Mathematical Institute Lomonosov Moscow State University

International School-Conference
GEOMETRY and QUANTIZATION
dedicated to the memory of the outstanding mathematician
Andrei Nikolaevich Tyurin

REGISTRATION FORM
(the marked positions must be filled up)

Given name (names):*
Family name:*
*	Male    Female
Date of birth (dd.mm.yy):*
Place of birth:*
Citizenship:*
Country:*
Affiliation, position:*

Mailing address:
Zip Code*		Country*		City*
Street*		Building No*		Office
Phone number		FAX number		E-mail*

Passport:
Number of the passport:*
Issue date of the passport:*
Exact expiration date:*
Warning: Your passport is supposed to be valid not less than 3 months from a date of your departure from Russia.

Children younger than 16: (if they accompany the invited person, don't have their own passports and consequently are indicated in the passport of the invited person)

(only the names and the dates of birth of these children in the same format as they are indicated in the corresponding passport; please, mention in whose passport the children are indicated)

Date of arrival:*		Date of departure:*
	Warning: If you come for more than 14 days please send us a pdf file with a copy of the first two pages of your passport
Places in Russia you are going to visit:*	Moscow

You prefer that your accomodation was supplied     by the Organizing Committee   or   by yourself

The address of residing in Moscow during visit:

Are you going to participate at the School as an attendee?   Yes   No
Are you going to give a talk?   Yes   No
The title of your talk:
Short abstract of the talk:
Key words:

The number of accompanying persons:
The names of accompanying persons:
Please, fill up the registration form for every accompanying person (mailing address, affiliation, position in this case are optional).

© Steklov Mathematical Institute, 2007