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Application form for QUARKS-2016

Please fill in all the fields in the following form and press the Submit button.

Family name:
First name:
Middle name:
Tentative title of talk:
Tentative date of arrival:
and departure:

Preferred accommodation:

Twin room (shared)               Suggested roommate:
Double room                         Accompanying person:
Double room for one person
I do not need an accommodation in Potemkin hotel

If you need Visa please send the Visa application form to with a copy to