APPLICATION FORM FOR A FINANCIAL SUPPORT
(to participants from C.I.S.)

(deadline for submission April 15, 2004)

Family Name:
First Name:
Sex:	Male Female
Position (title):
Organization:
Mailling Address:
City:
Code:
Country:
Phone:
Fax:
E-mail:

I would like to apply for a financial support for participation in the XVIIIth International Workshop in St. Petersburg (Russia, 17-23 June 2004) to cover:

Accommodation fee:	Yes No
Registration fee:	Yes No