Referee Expense Form

Name*
First Last
Email*
Address*
Street Address Address Line 2 City Province Postal Code
Phone*
CPU Number*
Event Name*
Address*
City
Date*
Date Format: DD slash MM slash YYYY
Hotel

Submit cost for Hotel based on Rates allowed. If rates are higher than normal please confirm with Referee Chairperson before submitting.
Receipt Uploads
Scan and upload any Receipts submitted
Referee Level
- National or Higher has sat 8 sessions or less in the year
- National or Higher that has sat more than 8 sessions in the year
- Provincial 8 sessions or less in the year
- Provincial that has sat more than 8 sessions in the year
Rates for level National or Higher - $70.00 Provincial - $50.00 A Referee that has officiated for more than 8 sessions in the year will have an increase in their stipend by $10 per session for each contest officiated thereafter. Please ensure you select the proper choice.
Number of Sessions
Select the number of full sessions refereed
Referees Traveling
- One Ref
- Two or more Refs
Kilometers Traveled
Enter to the nearest full Kilometer, no decimals.
Miscellaneous Expenses

Add any other expenses incurred here.
Comments:
Consent*
I agree to the privacy policy.
I agree the Expenses submitted are correct.
Date
Date Format: DD dash MM dash YYYY
Payment Type
Total
$ 0.00 CAD