Apply for a travel order with or without expense Before leaving on travel please fill in the form below. Your request will be forwarded to the secretariat of the Centre Borelli To know you : Civility (required) - Select -M.Mme Surname (required) First name (required) Email (required) Date of birth (required) Home Institution (required) Position or Profession (required) Nationality (required) Information concerning the travel : Mission (required) WITH EXPENSE WITHOUT EXPENSE Detailed raison for the travel (required) Motivation : Name and dates of the event, congress, symposium, seminar... Invitation, scientific collaboration, working group,... Exchanges within the framework of a contract,... Location of the mission : city (required) Location of the mission : country (required) Internet website Transport : Message Le transport fait l’objet d’un marché, prise en charge exclusive par le laboratoire. Date of departure (required) City of departure (required) Arrival city (required) Date of return (required) City of return (required) Route description Road map, preferred departure and arrival times, desired stops and details of your journey,... Means of transport Train Plane Bus Taxi Estimated cost of transport in euros Season ticket (N°) Expiry date Message Please visit the following website https://avenirclimatique.org/calculer-empreinte-carbone-trajet/ to estimate without generating it randomly the number of kgCO2e of your trip in order to report it in the field "Carbon footprint". Carbon footprint (transport) Interger kgCO2e Accomodation costs : Message L’hébergement fait l’objet exclusif d’un marché national et international (sauf exception) Accomodation-Hosting yes no Number of nights Restoration-food-meals yes no Number of meals Registration fees oui no Fees in euros Estimated total cost of the mission Financing Contract Acronym Comments Documents to be provided for exteriors - non-members of the Centre Borelli : Certificate of non-financial support from your home institution Upload Allowed types: gif, jpg, png, pdf, . Up to 4 MB. One file only. Bank account identity Upload Allowed types: gif, jpg, png, pdf. Up to 4 MB. One file only. I acknowledge that I have read the general conditions of use. Click here to consult them (required) Vérification antispam (required) Veuillez cocher la case "Je ne suis pas un robot" Preview
