Hockey Canada Course Expense Reimbursement Form (New Hamburg Hockey Association)
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Hockey Canada Course Expense Reimbursement Form
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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
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Number / Street Name
City
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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
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U7 Fundamentals Philly Orange
U7 Fundamentals San Jose Teal
U7 Learn to Play - L.A Grey
U7 Learn to Play - Dallas Green
U7 MD - Boston Yellow
U7 MD - Boston Black
U8 Minor Novice 1
U8 Minor Novice 2
U8 Minor Novice MD
U9 Novice MD
U9 Major Novice LL1
U9 Major Novice LL2
U11 Atom A
U10 Minor Atom A
U11 Atom BB
U11 Atom LL1
U11 Atom LL2
U11 Atom LL3
U11 Atom LL4
U13 PeeWee A
U12 Minor PeeWee A
U13 PeeWee BB
U13 PeeWee LL1
U13 PeeWee LL2
U15 Bantam A
U14 Minor Bantam A
U15 Bantam BB
U15 Bantam LL1
U15 Bantam LL2
U15 Bantam LL3
U18 New Hamburg Jr Firebirds
U16 Minor Midget A
U18 Midget BB
U18 Midget LL1
U18 Midget LL2
U18 Midget LL3
U18 Midget LL4
U21 Juvenile A
Goalie Clinic
Referees
Hitting Clinic
Position on Team
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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
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Clinic Date
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Attachment
Receipt & Certification Attachments
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Maximum # Files: 5. Maximum File Size: 4MB.
Please attach scanned copy of certitication
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Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 5. Maximum File Size: 4MB.
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