--------------------------------------------------------------------------- VISA SUPPORT FORM (please, return before February 15, 2006) Last Name : First Name : Date of birth (d,m,y): Place of birth : Citizenship : Passport number : Date of issue : Date of expiry : Place of work (full name of institution, firm, etc.): Position : Full address of work postal code: country: city: street: house: office: phone (with area code): fax: Dates of this visit to the Russian Federation - from : till : Cities to be visited (in addition to St. Petersburg): City with a Russian Embassy/consulate where you will apply for the visa : If you are accompanied by children younger than 16 years inscribed in your passport, please give - their name(s) : their year(s) of birth : The supporting letter (official invitation) must be sent to you: ( ) by mail ( ) by fax IMPORTANT: 1) Please fax to +7 (812) 428 7129 (for Vladimir Il'in) a copy of two adjacent pages of your passport which contain your photo, passport number and expiration date! Do likewise with the passports of all accompanying persons! 2) Please complete this form for each participant and accompanying person with exception of children younger than 16 years inscribed in your passport. 3) The visa support form must be sent not later than February 15, 2006. Otherwise we will not be able to facilitate your obtaining the visa. ---------------------------------------------------------------------------