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Referee Expense Form
Referee Expenses
Name
*
First
Last
Email
*
Address
*
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
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
E-Transfer
Cash
Cheque
Money Order
Total
$ 0.00 CAD