EUROMECH 495 REGISTRATION FORM
Fill out and email this registration form along with your abstract to 
Prof. Dmitry Pogorelov, pogorelov@tu-bryansk.ru or
Em. Prof. Dr.-Ing. Werner Schiehlen, schiehlen@itm.uni-stuttgart.de

Authors*:
		
Abstract title*:

Participant #1 
(for each participant / guest / accompanying person)
	
Title* (Dr., Prof., Mr.)		
First name*		
Surname*		
Name on badge		
Affiliation		
Postal address		
Phone*		
Fax*		
Email address*		

Information for visa application*
	
Nationality (state)		
State of residence		
Date of birth		
Place of birth		
Sex (male/female)		
Number of foreign passport or other identity card		
Date of expiry		
Affiliation (place of employment, position, address, phone&fax numbers)		
Date from and until (typically 16-23 February 2008)		
Path (typically Moscow-Bryansk-Moscow)		
Place of receiving a visa (state and town of the nearest consular office of Russian Federation)		

* required