The application form for participation 
in “The IInd international action of “The Nobel committee” (Norway and Sweden), 
the author of the unique cognitive modelling technology and the scientific direction 
"Cognitive computer science, cognitive modeling technology for system and financial analysis" 
("The AUT CMT SFA"), academician of "The RA(N)S" A.N. Vetrov, 
"The International Higher education academy of sciences" ("The IHEAS"), "The Russian academy of (natural) sciences" ("The RA(N)S"), 
"The SIO "Academy of cognitive natural sciences"" ("The SIO "ACNS""), 
The Administration of Saint-Petersburg city and The Government of The Russian Federation (RF) 
at support of The Presidents of The RF and foreign countries due to means of the budget, sponsors, interested and “The Nobel prize” – 
the procedure of the performance with the scientific reports and rewarding in organisations-participants, 
the presenters of diplomas, medals and “The Nobel prize” in “The Nobel committee”,
the creations of products as valuable monuments of architecture, town-planning and landscape-gardening art, 
important objects of historical, cultural, art and scientific heritage for (non)residents at the international level,
the demonstrations of achievements in the field of technology, architecture and building 
in "The park of the 50th-century of The Great October socialistical revolution named after V.I. Uljanov (Lenin)" 
and “The Saint-Petersburg exhibition center named after L.I. Brezhnev” (“The SPbEC”) 
at “Exhibition of achievements of science and technology named after A.A. Sobchak” (“The EAST”)
with the hotel accommodation "Karelia" ("Intourist hotel group")”
(it is filled by hand, since the 27th of December 2011 y. the list of reporters is formed)

(the name of organisation)

1. The organisation _______________________________________________________________
_______________________________________________________________________________

(the name of subordinated organisation)

2. The subordinated organisation ____________________________________________________

(the name of division)

3. The division __________________________________________________________________

(the name of post)

4. The post _____________________________________________________________________

(the name of scientific rank)

(the name of scientific degree)

5. The scientific degree ____________________ 6. The scientific rank _____________________

(the first name)

7. The first name _________________________________________________________________

(the middle initial name)

8. The middle initial name _________________________________________________________

(the last name)

9. The last name _________________________________________________________________

(the country and index)

10. The work address _____________________________________________________________

(the town and street)

(число, месяц, год)                                                                                                         (подпись)

_______________________________________________________________________________

 (the house and cabinet or office)

_______________________________________________________________________________

(the work phone number)

(the work fax number)

11. The work phone ________________________ 12. The work fax _______________________

(the work address of el. information resource WWW)

13. The work address of el. information resource (WWW) ________________________________

     (the work address of electronical post E-mail)

14. The work address of electronical post (E-mail) ______________________________________

(the country and index)

15. The home address _____________________________________________________________

(the town and street)
(город, улица)

_______________________________________________________________________________

                (the house and flat)
(город, улица)

_______________________________________________________________________________

(the home phone number)

(the home fax number)

16. The home phone ________________________ 17. The home fax _______________________

(the home address of el. information resource WWW)

18. The home address of el. information resource (WWW) ________________________________

(the home address of electronical post E-mail)

19. The home address of electronical post (E-mail) ______________________________________

 (the codificator UDC of scientific report from the list of “The VINITI RAS”)

20. The UDC and the name of scientific report _________________________________________

(the name of scientific report)

_______________________________________________________________________________
_______________________________________________________________________________

(necessary or not necessary)

21. The multimedia projector _______________________________________________________

22. The necessary add. equipment for the performance in “NC”, “The RA(N)S”, “The IHEAS” and “The SIO "ACNS"”

(not necessary or name of equipment)

_______________________________________________________________________________

                                                       (the code of sciences, abbreviation from the list of sciences)

23. The basic sciences in “The NC” __________________________________________________

                                       (the code of direction, abbreviation from the list of directions)

24. The basic scientific area in “The NC” _____________________________________________

                                 (the code of section, abbreviation from the list of sections)

25. The basic scientific section in “The NC” ___________________________________________

                               (the code of sciences, abbreviation from the list of sciences)

26. The add. sciences in “The NC” __________________________________________________

                                 (the code of branch, abbreviation from the list of branches)

27. The add. scientific area in “The NC” ______________________________________________

                                                         (the code of section, abbreviation from the list of sections)

28. The add. scientific section in “The NC” ____________________________________________

(the code of post, abbreviation from the list of posts)

(the code of post, abbreviation from the list of posts)

29. The post in “The SIO "ACNS"” ________ 30. The post in “The SRI "SFA CMT"” _________

(the code of post, abbreviation from the list of posts)

31. The post in “The SF "SFA CMT"” _________ 32. The post in “"The SPbEC" at "The EAST"” _________

(1-4 persons under the basic contract)

33. The own attendants in “The NC”, “The RA(N)S”, “The IHEAS”, “The SIO "ACNS"” ___ and at “The EAST” ___

         (1-4 persons under the additional contract)

34. The external attendants in “The NC”, “The RA(N)S”, “The IHEAS”, “The SIO "ACNS"” ___ and at “The EAST” ___

      (1-4 persons under the basic contract and 1-4 persons under the additional contract)

35. The quantity of the places in “The SPbEC” at “The EAST” ____________________________

(the quantity of posters)

(the quantity of places)

(the number of section)

(the number of pavilion)

36. The pavilion ____ 37. The section(s) ____ 38. The place(s) _______ 39. The poster(s) ______

     (none or type of printer)

(none or type of channel)

(the number of notebooks)

(the number of PCs)

40. The PC(s) __ 41. The notebook(s) __ 42. The Net/Internet _____ 43. The printer (MJ, BJ, LJ) __

44. The necessary multimedia devices for the demonstration at “The EAST” 

(not necessary or name of multimedia device: input, output, audio or video)

_______________________________________________________________________________

45. The necessary special devices for the demonstration at “The EAST”

(not necessary or name of special device)

_______________________________________________________________________________

      (1-5 pers. under the basic contr. and 1-4 pers. under the add. contr.)

46. The quantity of the places in the number(s) of the hotel “Karelia” _______________________

     (1-5 persons under the basic contract and 1-4 persons under the additional contract)

47. The quantity of the places on the buffet table at the restaurant of the hotel ____________________________
 We ask to confirm Your arrival not later, 
than for two months prior to the beginning of the current international action.

(the date (number), month and year)

(the signature of reporter)

        “____” __________________ 201 ___ y.	The reporter ____________________________