Hockey Canada Course Expense Reimbursement Form (New Hamburg Hockey Association)

Print Hockey Canada Course Expense Reimbursement Form

NHHA 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 resources section on the website and must be filled out along with a blank cheque to the Treasurer for automatic deposit.

Contact Information

First and Last Name^*
Address^*

Number / Street Name
City^*
Postal Code^*

A1B2C3
Contact Number^*

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^*

Example: [email protected]

Team Information

Which team are you requesting this for?

Select Your Team^*
Position on Team^*

Coach, Assistant Coach, Trainer

Clinic Information

Enter Information for the clinic attended

Type^*

Police check, Trainer, Coach
Level

Trainer / Coach Only
Fee^*

Enter the amount of the entry fee for this tournament
Clinic Location^*

Clinic Date^*

Open the calendar popup.

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.

Human Validation

Check The Box ^*

Hockey Canada Course Expense Reimbursement Form (New Hamburg Hockey Association)

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