Cheque Requisition Reimbursement Request (Tillsonburg Minor Hockey Inc.)
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Cheque Requisition Reimbursement Request
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Cheque Requisition Reimbursement Request
Personal Information
First & Last Name
*
Email address for contact
*
Example: yo
[email protected]
. Your submission will be sent to this address.
E-Transfer Email Address
*
Example:
[email protected]
Phone Number
*
519-555-5555
What team are you associated with?
*
Select One...
U18 Clinic
U15 Clinic
U13 Clinic
U11 Clinic
U9 Clinic
Girls - U9 Girls
U5
Girls - U11 Girls
U6
Girls - U13 Girls
U7
Girls - U15 Girls
U8
Girls - U18 Girls
U18 LL1
U18 LL2
U18 LL3
U18 LL4
U15 LL1
U15 LL2
U13 LL1
U13 LL2
U11 LL1
U11 LL2
U9 LL
U9 MD
What role do you hold on this team?
*
Select One...
Coach
Trainer
Manager
Board Member
Other
If "Other" role selected, please state which role.
Expense Information
What type of expense?
*
Select One...
Coaching Course Requirements
Trainer's Course Requirements
Manager Course Requirements
Board Expenses
Total Value of your Expense Request?
*
Add up the grand total of all invoices combined.
Upload all Receipts. Receipts must be original and be shared in their entirety.
*
Allowed extensions: .jpeg, .jpg, .png, gif, .pdf.
Maximum # Files: 10. Maximum File Size: 4MB.
How many receipts have you uploaded?
*
1 - I understand that all requests for expense cheques must be reviewed and approved prior to any funds being processed.
2 - I understand that all receipts must be provided in entirety for any reimbursements to be provided.
3 - I confirm that the receipts provided in this document are valid and factual.
I agree to the terms and conditions stated above
*
Human Validation
Check The Box
*
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