4th International Sakharov Conference on Physics

If you are an invited participant or an accompanying person, you are kindly asked to submit the Registration Form below.
By submitting this form you confirm that you plan to attend the 4th International Sakharov Conference on Physics in Moscow, May 18-23, 2009

Invitation needed for your visa can be issued based on
(1) Submitted Registration Form,
(2) E-mailed Photocopy of the passport page(s) containing the holder's photograph, name, passport number and expiration date.

Please make sure that all the necessary data are sent no later than March 19, 2009.

Family name:*

First name:*

Actual eMail:*

I need a Russian entry visa

Sex (f/m):*

Date of birth (dd/mm/yyyy):*

Country of birth:*

Place of birth:*

Citizenship:*

Country of residence:*

Place of residence:*

Affiliation:*

Work address:*

Position:*

Number of the passport with which you travel:*

Passport date of issue (dd/mm/yyyy):*

Passport expiration date (dd/mm/yyyy):*

Passport issued by (the authority):*

Country and city where the visa will be collected at a Russian Federation Consulate:*

Visa required from (dd/mm/yyyy)* to*

Destination in Russia in addition to Moscow:

I DO NOT need a Russian visa

Accompanying persons (yes/no):*

Name(s) of accompanying person(s) (if "yes"):

I need a reservation at the Sputnik Hotel

I need a reservation at the President Hotel

Indicate a Sputnik Hotel option 'S1', 'S2', 'SA',
or the President Hotel option 'PA'
(see Third Information Bulletin):

(if you have chosen option 'SA' or 'PA')
Print the chosen room option
(see Sputnik Hotel rooms,
see President Hotel rooms)

Hotel room required from (dd/mm)* to*

I do not need a room in the Sputnik Hotel or President Hotel and will arrange an accommodation in Moscow by myself

Please inform us where you plan to stay in Moscow:

Date of arrival* (dd/mm/yyyy):

Time of arrival (if known):

Arrival flight number/airport name (if known):

Date of departure* (dd/mm/yyyy):

Time of departure (if known):

Departure flight number/airport name (if known):

* required field

Comments**:

** SC4 Organizing Committee will have some capabilities for financial support of a limited number of participants.
If you need a financial support please indicate what type of support you claim
(see the Third Information Bulletin for details).

IMPORTANT NOTICE:
A separate Registration Form is required for each accompanying person.
Those who need the Russian entry visa do not forget to e-mail us the photocopy of the passport page(s) not later then March, 19.
If you have problem in filling in the registration form, please send an e-mail to the following address:
sakharov_conf@lpi.ru
Download the Form - MS Word file.

© 2009, Tamm Theory Department
Last update: March 12, 2009