Micro Internal Travel Grant Reimbursement Form

If funding for developing and/or producing this media outcome has been received by any other party, including any other funding from the European Commission, then this must be declared, and the claim adjusted accordingly.

NB: Although original (paper) receipts are not required to be submitted at the time of the reimbursement request, members are obliged to keep them for a period of at least five years, as the MCAA and/or the EC may, at any occasion, ask for them for auditing purposes.

If the member does not wish to keep the originals for five years, he/she should send them to:

INTRASOFT International. N.V. /S.A.

Project: Marie Curie Alumni Association (MCAA)

Tour Bastion, Place du Champ de Mars 5/10

1050 Brussels.

General Info

First Name

Last Name

E-mail *

Telephone

Event Fees

Event fee (if any) €

in Euros

Have you attended a physical event or an online event? *

Physical event

Online event

Travel Info

Departure City and Country

Please enter the City and Country. Wait for the autocomplete functionality and choose one of the options.

Arrival City and Country

Please enter the City and Country. Wait for the autocomplete functionality and choose one of the options.

Calculated distance

Departure Date

Return date

Travel Details

Means of travel used

Hotel / Accommodation

Expenses

Total Travel expenses (in Euros)

Total Subsistence / Accommodation Expenses

Total Expenses

(calculated automatically based on event fee, travel expenses, subsistence if any)

Upload the documents:

Travel tickets (or declaration with route if travelling by car); Boarding Passes are mandatory.

Allowed extensions jpg, gif, png, doc, docx, pdf, zip

Hotel Invoice

Meal(s) Invoice(s)

Registration fees invoice (if applicable)

Allowed extensions jpg, gif, png, doc, docx, pdf, zip

Declaration of Attendance at the event (mandatory) - self-declarations will not be accepted. Please try to obtain a declaration from the organisers of the event. *

Allowed extensions jpg, gif, png, doc, docx, pdf, zip

A news item, not more than 500 words, and two pictures describing the event attended shall be attached. *

Name of the Account Holder *

City and Country of the Account Holder *

Name of the Bank *

IBAN *

SWIFT Code *

Signature and date *

Payment of Expenses

Payments of expenses will be made by MCAA within twenty days from the date of reception of all documents required, and only through a bank transfer to an account held by the members in their own name. Proof of payment will be sent by e-mail to the Members as soon as it is made.

Comments

Disclaimer

The personal information submitted with this form is saved on ACQUIA Εuropean servers and an external IT company that works under contract with MCAA has access to them. Access to this personal data is granted to a very small number of EC personnel in case of audit and to the MCAA relevant staff of the appointed EC contractor, for the purpose of analysing compliance with the MCAA microfinance facility and processing reimbursements.