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:


Please note that the cheque will be issued in the name of the treasurer.

Treasurer’s Name:

Treasurer’s Signature:

Re-type your name in the field above

Treasurer’s Email Address:

Treasurer’s Student Number: