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Biographical data
(to be sent to nik@cea.ru or PO Box 3, Moscow, 115533, Russia)

Surname,Given names
Profession
Date,Place of Birth
Parents
Spouse
Children
Education(institute,degree,date)

Career


Achievements,Awards,Publications


Ideas,Projects

Personal Philosophy
Hobby
Publications about You

Address,Email,Website(for publication)

Address,Email(for verification purposes only)

I certify that the information overleaf is correct and may be published.

Signature ____________ Date _________________


Name & Address of Nominator
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