T R A V E L R E I M B U R S E M E N T F O R M

We will reimburse the cost of two delegates’ travel expenses from each support group. Please attach receipts (scanned ones are fine)

If driving, the mileage rate is 40p per mile.

Event / 2017 AGM and Conference – Edgbaston
Date / 13 June 2017
Group
Delegate
Name(s)
Journey Details
Amount (£)
Bank Details / Sort Code: / -- --
Account No:

Please return this form by email to

Or by post to:

Simon Lanyon

Tackle Prostate Cancer

15 Alwyn Avenue

London

W4 4PA

This event has been funded by Prostate Cancer UK

Tackle Prostate Cancer is the campaign name of The National Federation of Prostate Cancer Support Groups Charity Registration Nº 1163152

Registered Office: Kemp House,152 City Road, London, EC1V 2NX. A Company limited by Guarantee. Registered in England Nº 9672970