RAS Conference Advance Loan Request Form

Submitter Name*

Submitter Affiliation

Conference Information*

Provide: Conference Name, Location and Date

General Chair

Name and Email Address

Program Chair

Name and Email Address

Loan Amount Requested*

Brief Justifcation for Loan Amount*

Preferred Payment Method*

Select or enter value

Payment Details*

Provide Conference number and one of the following: Concentration bank account details, Local Bank mailing instructions for either a check payment or wire

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