BSIR Expenses Claim Form

Please fill in the claim form and upload the relevant receipts

Type *

Other *

Meeting Attended / Reason for Expenses *

Name *

Centre *

Address *

Tel *

Email *

Details of Expenses

Amount

Details of Expenses & Amounts

Expense 1

Amount 1

Expense 2

Amount 2

Mileage

Total Claimed

0.00

Bank Details

Name of Bank

Address of Bank

Bank Sort Code

Bank Account

Name on Account

International Transfer

Swift No

BIC

IBAN No

Route/Branch No (USA)

Receipt

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British Society of Interventional Radiology (BSIR)
The Royal College of Radiologists
63 Lincoln's Inn Fields
London WC2A 3JW

Registered Charity: 1198888