Campus Life Expense Form

Campus Life Expense Form

Complete this form to receive reimbursements for expenses accrued for Campus Life Programs and honorarium's.
Student Information

If your Student Group is not listed below, and you are a SMCSU recognized club, please complete this form instead: https://usmcsu.ca/reimbursements
I am submitting this form for...

ReimbursementHonorarium
What Student Group are you a part of?*

Alumni Mentorship Program (AMPlify)Commuter CoorinatorsMentorshipOrientationSMC TroubadoursWork Study: WellnessWork Study: Social MediaStaff
Please specify your role
For example, Orientation Marshal or Orientation DJ
Name*

First NameLast Name
Email*
example@example.com
Student Number*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SIN Number*
In order to write cheque, your SIN number is required.
Date of Birth*

MonthDayYear
Date
Direct Deposit Form*

Campus Life Program expenses are typically reimbursed by Direct deposit, please upload your Direct deposit or Void Cheque form here.
Cancelof
Expense Information
File Upload*

Label each receipt as follows: Your Name, Receipt 1 (Karina Stellato, Receipt 1) *Please make sure your receipt number corresponds with the information in the chart below*
Cancelof

Please provide the total amount to be reimbursed from the above receipts*
Statement of Understanding

Please read and agree to the statement of understanding below in order to complete your request.
1. I, your full name* understand that completion of this form is the first step to being reimbursed for expenses accrued for Campus Life events. Reimbursement is subject to review by Campus Life staff. Please allow at least 3 weeks for reimbursement from the time of submission.
Should be Empty:

	Receipt Date (e.g. 2023-05-01)	Vendor Name (e.g. Tim Hortons)	Receipt Total (e.g. 23.23)	Receipt Type (e.g. Supplies)	Purpose/Event (e.g. Commuter Orientation Gift card for Karina Stellato)
Receipt 1
Receipt 2
Receipt 3
Receipt 4
Receipt 5
Receipt 6
Receipt 7
Receipt 8
Receipt 9
Receipt 10

Expense Information