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APPLICATION FOR PARTICIPATION IN THE CONFERENCE Surname _____________________________________ First name____________________________________ Patronymic___________________________________ State________________________________________ Position _____________________________________ Name of institution / educational institution_____________________________________ Degree _______________________________________ Title _________________________________________ Telephone, E-mail: _____________________________ Home Address _________________________________ Research manager (name, academic degree, academic rank, position, educational institution (institution)____________________________ Co-author _____________________________________ Theme reports __________________________________ Section ________________________________________ Do you need hotel*? _____________________________ Would you like to publish thesis? ___________________ Signature Date ________________________ *About accommodation please call 044-406-70-35 no later than 14 days before the conference |