SAMHA Coaching Reimbursement
All coach clinic reimbursement cheques will be issued on November 15th. Any claims after this date will be reimbursed January 2024. *Only fully completed courses are eligible for reimbursement. **Must be registered on 2023-2024 SAMHA or Raiders roster.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please indicate the division you have applied to coach in the 2022-2023 season:
U7
U9
U11
U13
U15
U18
Date of Clinic:
-
Month
-
Day
Year
Date
Clinic Description:
Course:
Coach 1
Coach 2
Respect in Sport Activity Leader
Safety Online
Coach 1/2 online
Checking online
Checking 1
Please specify
Please upload a picture of your receipt showing the PAID status.
*
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of
please upload a picture of your COMPLETED COURSE EMAIL OR CERTIFICATE (certificate preferred)
*
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Submit
Should be Empty: