Application sample Author: (surname, first name, patronymic) Academic title: _____________________________________________ Organization: _____________________________________________ Appointment: _____________________________________________ Address for correspondence: _____________________________________________ Phone: _____________________________________________ E-mail: _____________________________________________ Paper title: _____________________________________________ Co-authors: _____________________________________________ Section name: _____________________________________________ I plan to: □ make a plenary report □ make a section report □ virtual participation