SSNL PN Nutrition Grant Remittance Form
Use this form to get re-imbursed for purchased.
Name
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First Name
Last Name
What is the name of your School
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Reimbursement Options
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Made Payable to You
Made Payable to the School.
Mailing Address to send reimbursement
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Street Address
Post Office Box number
Municipality
Province
Postal Code
WHEN DID YOUR EVENT TAKE PLACE?
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WEEKDAY AFTER SCHOOL EVENT- COMPLETE A. NUTRITION GRANT EXPENSES
SAT/SUN - 6 Hour EVENT- COMPLETE B. NUTRITION GRANT EXPENSES
A. Nutrition Grant Expenses Festival of Sports during the Weekday 3-6pm. Up to $1.00 per student will be allocated to pay for fruit and vegetables. If you purchased other personal items on the receipt please cross them out and adjust the total on the bottom of your receipt. If you have multiple receipts please use the calculator and ensure you transfer the answer into the A. Total Nutrition Reimbursement Box.
Date of Event
How many students participated
1
Please upload a photo of the receipt(s). In the case of multiple receipts-please ensure you take one photo of all receipts. Include the total of all receipts of funded nutrition into Box A total below.
Calculator
A. Total Nutrition WEEKDAY Reimbursement
B. Nutrition Grant Expenses- WEEKEND Festival of Sports or Jamborees lasting 6 hours. A one-day event being held on a Saturday or Sunday for a minimum of 6 hours will be eligible to receive a healthy lunch for each participant and volunteer. A healthy lunch consisting of a sandwich or wrap or soup and sandwich, and a piece of fruit to a maximum of $500. If you purchased other personal items on the receipt please cross them out and adjust the total on the bottom of your receipt. If you have multiple receipts please use the calculator and ensure you transfer the answer into the B. Total Nutrition Reimbursement Box.
Date of Event
How many students participated
1
Please upload a photo of the receipt(s). In the case of multiple receipts-please ensure you take one photo of all receipts. Include the total of all receipts of funded nutrition into Box B total below.
Calculator
B. Total Nutrition WEEKEND Reimbursement
Your Box A or B total automatically calculated in this box. This is the amount SSNL will reimburse. Please verify the Total below.
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Claim Date
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Month
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Day
Year
Date
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