Reimbursement Form for Meeting Organizers at FEBS Events

Meeting Details

Name of FEBS EventSelect the event

Meeting Title *

Name of IUBMB Speaker *

Location *

Number of days Meeting Attended *

Start Date of Meeting *

Year *

Month *

Day *

End Date of Meeting *

Year *

Month *

Day *

Bank Account Details

First Name *

Middle Name

Last Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Email Address *

Phone

Name of Account Holder *As spelled on the bank documents

Bank Name *

Bank Address *

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

SWIFT / BANK / BIC *

ABA Code / Routing Number (US)

*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

Reimbursement

Please convert all expenses into the same currency. Use Oanda for the day payment and attach a copy to your claim.

Total Amount to be Reimbursed *

USD

Organizers are entitled to receive a financial support of up to US $2.000 from IUBMB to cover partial or full expenses of maximal one “IUBMB Speaker“ hosted by a single FEBS event.

Upload Receipts and Invoices *

Name of Organizer(s) *

Signature of Organizer *

Save as Draft