Hockey Canada Course Expense Reimbursement Form (Wilmot Girls Hockey)

Hockey Canada Course Expense Reimbursement Form

WGHA reimburses 100% of the cost of Hockey Canada accreditation clinics. To be reimbursed, coaches must provide the association Treasurer with proof they have successfully completed the course. The Clinic reimbursement form can be found in the Coaches & Staff section on the website and must be filled out along with a blank cheque to the Treasurer for automatic deposit.

Date

Contact Information

First and Last Name^*

Required

Address^*

Required

Number and Street Name

Town / City^*

Required

Postal Code^*

Required

e.g. N3A1Z1

Phone Number^*

Required

Example: ###-###-####

Email Address for Reimbursement

CAREFULLY enter the email address where you would like us to send payment. Please understand that if you enter the wrong email address on this form, your payment may be permanently lost.

Email Address for payment by e-transfer*^*

Required

Example: [email protected]

Team Information

Which team are you requesting this for?

Name your team^*

Required

Position on Team^*

Required

Coach, Assistant Coach, Trainer

Clinic Information

Enter Information for the clinic attended

Type^*

Required

Police check, Trainer, Coach

Level

Trainer / Coach Only

Fee^*

Required

Enter the amount of the fee for this clinic

Clinic Location^*

Required

Clinic Date^*

Required

Attachment

Receipt & Certification Attachments

Please attach scanned copy of receipt^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 5. Maximum File Size: 4MB.

Please attach scanned copy of certitication^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 5. Maximum File Size: 4MB.

Hockey Canada Course Expense Reimbursement Form (Wilmot Girls Hockey)

Contact Information

Email Address for Reimbursement

Team Information

Clinic Information

Attachment

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