Travel Reimbursement - The Amos Bursary

How Your Information Will Be Used
- The information you provide is used to process your travel expense claim
- All information on this form is kept confidential
Once we have received your claim you will receive an email confirmation. Your claim will be processed within a month of receipt.

Should you have any questions, please email [email protected]
Details
Title:*
First Name:*
Surname:*
Email*
Cohort (AB students only)*
Which year did you join the Bursary?
Your relationship with AB
University Attending*
Event Attending*
Date of Event*
DD slash MM slash YYYY
Cost of Ticket(s) - (format xxx.yy)*
Please enter a number from 0.00 to 100.00.
(e.g. xx.yy)
Payment Details
PLEASE PROVIDE YOUR BANK DETAILS HERE IF YOU HAVE NEVER RECEIVED A PAYMENT FROM THE BURSARY BEFORE.NAME ON YOUR BANK CARD: SORT CODE: ACCOUNT NUMBER:
Receipt Upload (Optional)
Attach Receipt(s)
Drop files here or
Accepted file types: pdf, doc, docx, jpeg, tiff, Max. file size: 16 MB.
Privacy Policy & Data Retention*
- Please click here to confirm you are happy for us to retain information supplied in your application form.
If you would like more information about how we process your data, please visit: https://www.amosbursary.org.uk/privacy
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How Your Information Will Be Used