POLYSLAV-XX
September 4-11, 2016, Moscow
Application Form

1.		Last name, first name (in Roman script and Cyrillic if applicable)		
2.		Academic title		
3.		Affiliation and work address		
4.		E-mail (private)		
5.		E-mail address (official, if applicable)		
6.		Phone number (private)		
7.		Phone number (official, if applicable)		
8.		Subject of the contribution		
9.		Language of the contribution 		
10.		Abstract of the contribution (for the new members only)		
11.		Technical equipment needed for presentation of the paper
(overhead projector/beamer)		
12.		Date of birth		
13.		Nationality		
14.		Do you need an invitation to apply for a visa to Russia?		
15.		Estimated date of arrival to Russia		
16.		Estimated date of departure from Russia		
17.		Address for invitation		
18.		Date