Clearance for research activities abroad for students

Personal and account information:

Last name: Click and enter data	First name: Click and enter data

Date of birth:	Gender: female male
Date format dd.mm.yyyy

Address: Click and enter data

Email-address: Click and enter registration number@students.vetmeduni.ac.at

Nationality: Click and enter data

Owner of the account: Click and enter data

IBAN: Click and enter data	BIC: Click and enter data

Austrian bank institution: Click and enter data

Costs of travel and accommodation:

Bills and receipts:	Amount of the fund:

Airfare:	€	€ __________

Train costs:	€	€ __________

Other kind of transport:	€	€ __________

Accommodation:	€	€ __________

Total:	€	€ __________

Anweisung des Förderbetrags zulasten FO660-FAK: (Will be filled in by IRO)

Bereits angewiesener Betrag:	€ __________

Restbetrag:	€ __________

Datum: __________	Unterschrift:

Only with original documents