Chinook Winds 2023 Gathering Expense Form

2023 Regional Gathering Volunteer Expense Form

Chinook Winds Region - The United Church of Canada
Submitting your expenses for the Chinook Winds Regional Gatherings requires completing the following three steps:

1. Fill out the following form. Then print the form (print button is at located at the bottom).

2. To submit your form, there are two options:

(i) you can email a scanned version of your form along with copies of relevant receipts to Chinookwinds@united-church.ca for approval. OR

(ii) Mail the form and relevant receipts to Chinook Winds Regional Office for approval. Address: P.O. Box 98; Okotoks, AB T1S 1A4.

3. Register for Electronic Funds Transfer (EFT). Payment for expenses will be made by Electronic Funds Transfer (EFT). Please see the instructions within the form to register with Chinook Winds to receive payment by EFT.
Pay to:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email:*
example@example.com
Requested by:*
Date:*

MonthDayYear
Date
Event:*
Event Start Date:*

MonthDayYear
Date
Event End Date*

MonthDayYear
Date

Other Travel Costs

	Amount
Air/Bus/Taxi ($ amount)
Other ($ amount)

Mileage

(Please select number of delegates traveling in the same vehicle and enter number of Km travelled, form will calculate amount to be claimed based on $0.40 a KM)
Mileage rate based on number of delegates
Read only field
Number of delegates traveling in same vehicle

1 Delegate ($0.15 a Km)2 Delegates ($0.20 a Km)3 or more delegates ($0.25 a Km)
Number of Km you are claiming
Amount being claimed for mileage
Sub Total Travel Costs
Donate this amount of my reimbursement to Chinook Winds Region
Total Claim
Register for EFT

Payment of expenses are being made by Electronic Funds Transfer (EFT).
- Download direct deposit fillable PDF form by clicking here.
- Fill in form and save your answers.
- Email your filled in EFT form to chinookwinds@united-church.ca
I acknowledge that:*

I have downloaded the EFT form above and it has been/will be emailed to chinookwinds@united-church.ca
Approval
Approved by Name
Date

MonthDayYear
Date
Approved by Signature
Any additional comment or verification
If needed

Office Use Only

To have your expenses approved for payment, please complete the following steps:

1. Print your completed form.

2. Scan your form and receipts and email to ChinookWinds@united-church.ca or mail to Chinook Winds Region Office P.0. Box 98, Okotoks, AB T1S 1A4.After printing form send to approver together with the receipts, OR preferably, send the form and receipts in PDF format electronically to the approver.
Should be Empty:

2023 Regional Gathering Volunteer Expense Form