--------------------  REGISTRATION FORM  --------------------
                 
                 The  International Conference

             "NUCLEAR STRUCTURE AND RELATED TOPICS"

                Dubna, June 6 - 10, 2000

                           REGISTRATION FORM

 NAME:..............................................................

 FIRST NAME: .......................................................

 I intend to participate in the Conference (yes, no):...............

 I would like to give a talk on: ...................................

 ...................................................................

 MAILING ADDRESS:...................................................

 Phone:.........................   Fax:.............................

 E-mail: ...........................................................

 CITIZENSHIP........................................................

 Please, return  to:

 E-MAIL: nsrt2000@thsun1.jinr.dubna.su

 FAX:   (7-09621) 65084

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