Cheque Requisition Reimbursement Request (Tillsonburg Minor Hockey Inc.)

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Print 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?^*
What role do you hold on this team?^*
If "Other" role selected, please state which role.

Expense Information

What type of expense?^*
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 ^*