International Forum “Modern Information Society Formation
– Problems, Perspectives, Innovation Approaches”
1–5 June, 2015, Saint-Petersburg, RUSSIA

Registration form for participation

1. Title (Prof. / Dr. / Mr. / Ms.) 

 2. Sex 

3. Last name 

4. First name 

5. Profession / Position 

6. Company 

7. Address: 

 home / 

 office
Street address / PO Box

City 

Post / Zip code 

 Country 

Phone 

 Fax 

 Email 

8. Passport # 

 9. Date of birth (dd/mm/yy) 

10. Date of issue (date of expiry dd/mm/yy) 

 11. Valid until (date of expiry dd/mm/yy) 

12. Date of arrival to Russia (approximately – this date will
be pointed at your invitation for getting entrance visa)

	
13. Date of departure from Russia (approximately – this date will
be pointed at your invitation for getting entrance visa)

	
14. Cities for visiting in Russia 

15. City, where you prefer to get you visa (Russian Embassy
or Consulate should be there)

	
16. Are you coming with accompanying person? 

 yes / 

 no
Name of the accompany person 

17. Do you plan to submit paper? 

 yes / 

 no

If you answer “Yes” on the question #16, please, answer next questions too (questions 18–31)

International Forum “Modern Information Society Formation
– Problems, Perspectives, Innovation Approaches”
1–5 June, 2015, Saint-Petersburg, RUSSIA

Registration form for accompanying person

18. Title (Prof. / Dr. / Mr. / Ms.) 

 19. Sex 

20. Last name 

21. First name 

22. Profession / Position 

23. Company 

24. Address: 

 home / 

 office
Street address / PO Box

City 

Post / Zip code 

 Country 

Phone 

 Fax 

 Email 

25. Passport # 

26. Valid until (date of expiry dd/mm/yy)  

 27. Date of birth (dd/mm/yy) 

28. Date of arrival to Russia (approximately – this date will
be pointed at your invitation for getting entrance visa)

	
29. Date of departure from Russia (approximately – this date will
be pointed at your invitation for getting entrance visa)

	
30. Cities for visiting in Russia 

31. City, where you prefer to get you visa (Russian Embassy
or Consulate should be there)

	

Please submit your completed registration from and copy of the first page
of your passport with following information: passport number, date of issue
and your full name to the Organizing committee.