IUBMB Focused Meeting

Bank form – IUBMB Focused Meeting

Meeting Title

Start date

End date

Total amount

USD

Enter approved amount.

Bank Account Details

First Name

Middle Name

Last Name

Full Mailing Address

Street address, City, Province, ZIP/Postal code, Country

Phone

Name of Account Holder

As spelled on the bank documents

Bank Name

Bank Address

City and State only

Account number

*IBAN format for non-US banks; *Canadian bank format is branch transit-financial institution-account number

SWIFT / BANK / BIC CODE

ABA Code / Routing Number (US)

nine-digit string

*You will need to provide the full mailing address of the branch where the account is if you do not have any of the codes

Address

*I verified that the provided account details are accurate and can receive bank transfers from abroad and in USD (checkmark if you confirm)

I CONFIRM

Please note that 50% of the support is provided 3 months before the event, 20% is provided just before the event upon receiving the list of participants, and the remaining support of 30% will be paid once the meeting has successfully taken place and a report has been provided.

I accept the payment terms

Name of organizer(s)

If you are human, leave this field blank.