IUBMB Reimbursement Form for IUBMB Meetings Bank form – Advanced Schools IUBMB Advanced Schools Meeting Title * Location * Number of days meeting attended * Start date * End date * Total amount * USD Enter approved amount. The total maximal amount is USD $20,000 Bank Account Details First Name * Middle Name Last Name * Full Mailing Address * Street address, City, Province, ZIP/Postal code, Country Email * 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) * Submit If you are human, leave this field blank.