Cheque/Reimbursement Request Form (Clearview Minor Hockey)

Cheque/Reimbursement Request Form

This form is to be used when requesting reimbursement for expenses paid.

Request Date: ^*

Required

Team Name: ^*

Required

For example: U15 rep, U11 LL #2 etc.

Requesters Name: ^*

Required

Requesters email address^*

Required

Preferred payment method^*

E-transferCheque

Required

Payable to: ^*

Required

Email address if e-transfer was selected. Name if cheque was requested.

Amount to be issued: ^*

Required

Purpose of reimbursement^*

Required

For example: pay tournament fees from team sponsorship

I acknowledge that all information provided on this form is true and correct.
Once submitted this form will be forwarded to the CMH president, treasurer and secretary for review and approval.

Please note: Requests are processed on the weekly.

I agree to the terms and conditions stated above^*

Cheque/Reimbursement Request Form (Clearview Minor Hockey)

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