Speakers reimbursement form

If funding for travel or subsistence for this event 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: Marie Curie Alumni Association. Avenue des Arts, 24. B-1000 Brussels.

General Info

First Name *

Last Name *

E-mail *

Telephone

Event 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

Date of Departure from Destination *

Date of Arrival at Destination *

Means of travel used *

Hotel / Accommodation *

A) Total Travel Expenses: * €

in Euros

B) Total Accommodation Expenses: * €

in Euros

C) Total Expenses (A+B): * €

in Euros

Upload the documents

List the documents attached to this form:

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

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Comments

Bank details for payment

Name of the Account Holder *

City and Country of the Account Holder *

Name of the Bank *

IBAN (or account number) *

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.

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.