Gift Card Receipt

Gift Card Receipt
This form should be submitted with all reimbursement requests where a gift card was provided to another individual.
To Be Completed by Gift Card Receiver
Name

First NameLast Name
Email
example@example.com
Date gift card was received:

MonthDayYear
Date
Gift card number:
Signature of receiver:

Clear
Amount received ($):
To Be Completed by Club/DSU Representative
Name of club/DSU executive:

First NameLast Name
Email
example@example.com
Where is this money coming from?

Trust Account:Grant Account:
Trust Account Number:
Grant Account Number:
Amount of cash provided for gift cards (CAD $):
Amount granted (if applicable):
Signature

Clear
Date:

MonthDayYear
Date
Please return this form along with the cheque requisition form and any associated documents to the SFSS General Office (MBC 2270) for your reimbursement request to be processed.

If there are any questions, contact the SFSS General Office at 778.782.3870 or
at studentcentre@sfss.ca
Should be Empty: