Under 18's First Selection Event Reimbursement

I want to extend my heartfelt thanks for all the effort you put into the Under 18's first selection trial. It was a great success, and we could not have made it work without your dedication and hard work.

As we wrap up our selection 1 trails, please take a moment to complete the reimbursement survey along with the necessary supporting documentation. If you encounter any issues, I will reach out to you; however, if you don’t hear from me, everything is in order.

Hockey wouldn’t be as great as it is without your contributions, and here at Hockey NSW, we truly appreciate all that you do.

Best regards,

Sharon

PERSONAL DETAILS

Name*

Phone Number*

Email Address*

Event*

Your suburb and postcode*

Position held at event*

Date(s)*

REIMBURSEMENT OF KM

TRAVEL = $0.35/km (minimum 10km) E.G - Sydney Olympic Park > Moorebank > Sydney Olympic Park Total Kms = 45.2 Cost = $0.35 x 45.2 = $15.82

Details of Reimbursement (From > To = Total KMs)

Total Amount (Milage)

OTHER

Details of Reimbursement (Other)

Total Amount (Other)

BANK ACCOUNT DETAILS & TOTAL AMOUNT

BSB Number*

Account Number*

Name of Account*

TOTAL AMOUNT (Travel + Other)*

Have you changed your bank details since your last Hockey NSW reimbursement?*

SIGNATURE - I acknowledge that the information obtained in this form is true and correct as of the date mentioned.

Signature (Print Name)*

Date*

RECEIPTS

Please upload any receipts.

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