1. Last name(s) (as in passport):

2. First name(s) (as in passport):

3. Date of birth (dd-mm-yy):

19

3.1 Place of birth :

country city

4. Mr/Mrs:

5. Nationality:

6. Passport number:

7. Passport expiration date (dd-mm-yy):

20

8. Affiliation:

9. Position:

10. Address (official)

street address:

city:

postal code:

country:

13. Dates of visit:
(if not determined yet please put the earliest possible date of your arrival;
the visa will be given for 30 days beginning from this date)

from:   to:

14. Сountry & city (with a Russian consulate) where you will apply for a visa:
(you may find list of Russian consulates at
this list of consulates but please DO check it)

15. Fax copy of the official invitation is
SUFFICIENT / NOT SUFFICIENT
to obtain the visa in this consulate
Note: in many Russian consulates the invitation by fax is NOT sufficient to obtain the visa. Please, DO contact the consulate to clarify this question.

SUFFICIENT
NOT SUFFICIENT

16. Fax number/Mailing address to send the invitation to:
(please put fax number if fax copy of invitation is sufficient)

17. Russian cities planned to visit

1 2
3 4

I would like to come with accompanying person(s):
If "yes", please, make a separate visa form for each accompanying person:
fill in the same fields for everyone
(DO NOT omit affiliation, position, address and fax of the institution
FOR EMPLOYED and FOR STUDENTS or PUPILS).

yes no

Their names:

1 2
3 4