Reimbursement Form

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Reimbursement Form

**Heads Up: This form must be filled after the event.

Reimbursement Form

"*" indicates required fields

Step 1 of 3

Event Name: Unlocking Clinical Trials: From Design, to Participation and Beyond

6th and 7th December 2024
Lisbon, Portugal

Submitter's Information

Member's Information*

First Name Last Name

Association*

Select the Association you belong

Position*

Select your position in the Association

Address*

City Country

Email*

Enter a valid email address, and be aware of any typos.

Phone Number*

Please don't forget to add the country code

Reimbursement Information

Reimbursement will be granted only upon proof of purchase.
This includes:

Travel expenses such as:

public transportation

train tickets: 2nd class

flights: economy class)

taxis (transfers between home address-airport/train station-hotel in the congress city and back)

overnight stays in mid-class hotels (if not booked by SE) with breakfast option included for the SE individual in the overnight hotel booking.
Any additional expenses including all administrative costs of any kind, taxis (apart from the arrival and departure transfer mentioned above), additional hotel nights, food & beverages, internet and / or phone charges, costs for accompanying individuals will not be reimbursed. Any exceptions to these rules are to be approved by the Sjögren Europe President in writing.

Expenses Analysis

Review the list of expenses below.

Select the ones that apply to your participation.

For each selected expense, provide the exact corresponding amount.

Ensure you choose a new expense from each field, and repeat the process for every relevant expense within the given categories.

It's not mandatory to choose all expenses.

The total amount will be calculated at the end.

Expense #1*

Select from the category the relevant expense

Amount*