Reimbursment Form Europe – Bradykinin Symposium

APPLICATION FOR

For travel cost reimbursement please fill in this form and submit it with your travel receipts after the meeting.

Maximum reimbursement amount: 600 €

First name (That is linked to your bank account)

Last name (That is linked to your bank account)

Title

Institution

Address

City

E-mail address

Phone

Travel expenses (If you have multiple documents, please combine them into a single PDF file before submitting via the file upload button.)

File upload

Bank

Personal account number

Bank code

IBAN

BIC (Swift)

Please provide your consents.

I hereby confirm that the information provided is accurate.

I consent to the processing of my data in accordance with the DSGVO (GDPR). Please see below.

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PROFESSIONAL CONGRESS ORGANISER

Remember Management GmbH
Albrechtstr. 14 b, 10117 Berlin, Germany
Phone: +49 30 47 37 25 77
Fax: +49 30 47 37 25 78
E-mail: bradykinin@remember-management.de
Web: www.remember-management.de

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