Registration Form

Please copy this form, fill in and send it by e-mail to ankaurban@mail.ru as soon as possible. If you need an invitation for visa application, please also send the clear scanned copy of the photo/information page of your passport.

 

Family name

 

Given name(s)

 

Date of birth (day/month/year)

 

University/Institution

 

Position

 

Full postal address of the university/institution

 

Phone/fax

 

E-mail

 

Presentation form (oral/poster)

 

Theme (select from the Conference themes)

 

Title of presentation

 

Participation in the Field Workshop (Yes/No)

 

If you need an invitation, please give below further personal information

Citizenship

 

Place of residence (country and region)

 

Place of birth (city, region, and country)

 

Sex (male, female)

 

Passport number

 

Passport issued (day/month/year)

 

Passport expiration (day/month/year)

 

Planned date of your entry into Russia (day/month/year)

 

Planned date of your exit from Russia

 

List of cities to be visited in Russia (max. 5)

 

City and country where you will apply to the Russian Embassy or Consulate for a visa.

 

 

 

Unless stated otherwise, all photographs on this website are by the Melnikov Permafrost Institute staff members
(Sergey Serikov, Yuri Murzin, Leonid Gagarin, Mikhail Grigoriev, Alexander Fedorov, Sergey Gulyi, Ivan Vakhrin, Andrey Litovko, Stepan Varlamov and others).


Siberian Branch | Russian Academy of Sciences

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