Appendix 5
Funding Reimbursement Form

A Club Event / Activity Form must be completed before a Funding Reimbursement Form is submitted.

Name of Club:


Amount Spent:


(Attach receipts using the browse buttons below. Each file should be 2 MB or less)











Purpose of Expenditures:


Signing Officers of Club
(Please note that the cheque will be issued in the name of the two signing officers)

Signing Officer:

Signature:

Re-type your name in the field above

Email Address:

Student Number:

Signing Officer:

Signature:

Re-type your name in the field above

Email Address:

Student Number: