SpeakerReimbursement

Banking Information for Speaker Reimbursement

* Indicates required field

Name *

First

Last

Email *

Institution *

Name of bank *

Country *

Preferred currency *

Address of bank *

SWIFT / BIC code *

Name of beneficiary (as in bank account) *

Account number *

Beneficiary's address *

For submission, please compile all your documents relevant to the reimbursement into a single PDF file and submit using the 'Upload' button below.

Please upload your document here: *

Max file size: 20MB

Comments, if any *