The XII International Youth Oil & Gas Forum

The XII International Youth Oil & Gas Forum

A registration form of a conference participant

1. Name:
(First name) (Middle name) (Last name)
2. Date of birth:

Permanent residence address registration

Country:		Postal index:
Region:		city:
Street:		Building number:
Building:		Flat / office:
Telephone:		Fax:

Conference participant’s information

A resident of the Republic of Kazakhstan Not a resident of the Republic of Kazakhstan

	Section:
	A theme of the report:
	University:
	Department:
	Specialty:
	Degree (B’Sc, M’Sc): Course:
	Contact telephones:
	E-mail:
Supervisor:
(academic degree)
(First name) (Middle name) (Last name)

Дата добавления: 2015-11-04