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REGISTRATION FORM

International Workshop
e+e- Collisions from Phi to J/Psi
March 1 - 5, 1999

Budker Institute of Nuclear Physics, Novosibirsk, Russia

(items marked with * are optional)


Dead-line for registration December 25, 1998

Name (as it should appear on badge):
Mr Mrs
Home Institution:

Street Address:
City:
Postal Code:       Country:
Phone:       Fax*:
E-mail:

Personal data necessary for visa

First and last name as in passport*:

Date of Birth*:
Place of Birth*:
Citizenship (Country)*:
Passport Number*:
Title of the talk*:
Hotel reservation (arrival and departure dates)*

Payments of the registration fees

The registration fee (including breakfasts, lunchs, coffee breaks, the reception, the Conference dinner, the excursion, Conference briefcase and the Proceedings) is 300 US dollars paid directly during the registration.


Comments:
    



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Last modified on Questions and comments are welcome to
31-Oct-1998 vepp99@inp.nsk.su