P.N. Lebedev Physical Institute
Russian Academy of Sciences

International Conference
P.A. Cherenkov and Modern Physics

Moscow, June 22 - 25, 2004

Registration Form

(Required fields are marked by asterisk)

Name (*)  

First name (*)             Initial(s)  

Affiliation (*) 

Post address (*)  


E-mail (*)


Participance (*):      Full          Guest

Full participant: pays the conference fee during registration; receives a conference badge, a conference pack, and (after conference) conference proceedings sent to the indicated post address; gets free lunches and the conference dinner.

Guest participant: does not pay the conference fee; receives a conference badge; pays lunches and the conference dinner him/her self.

Coffee is served to everybody.


Need a room in the Hotel "Uzkoe" (*):        Yes        No

        if yes:     since          until  


special needs or message to the Organizing Committee