NSWPSA Training & Seminar Reimbursement Form

NSWPSA Training & seminar subsidy application form
Name*

First NameLast Name
Mobile Phone Number*
E-mail*
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Address

Street Address

Apt/Unit #

CityState

PostcodeCountry
NSW PSA ID Number*
Please select to ensure you meet the eligibilty requirements below
Eligibility Criteria*

I am a current financial member of NSWPSAI have been a financial member of NSWPSA for 2 or more yearsThe training/seminar selected will directly improve/benefit your coachingThe training/seminar is an approved course by NSWPSAI am only applying for one subsidy
Name of Approved seminar Attended*
Start Date*

DayMonthYear
Date
End Date*

DayMonthYear
Date
Training & Seminar Subsidy/Grant Application Approval Date

DayMonthYear
Date

Subsidy Request*

	Total Expense (incl GST)	Funding sought from NSWPSA
Training/Seminar Course Costs
Travel by Car (if training is more than 100km from workplace)
Travel by Air (if training is more than 100km from workplace)
Accommodation (if training is more than 100km from workplace)

Attached Information

Please ensure all relevant documents are attached including:-
- Training seminar/course invoice/receipts
- Travel by Air - confirmed flights and payment confirmation (where applicable)
- Travel by Car - documentation demonstrating km's travelled (for petrol reimbursement) where applicable
- Accommodation - booking and payment confirmation/receipts (where applicable)
- Your itemised Tax Invoice for the amount being claimed as permitted under the Training & Seminar Application Policy (including your ABN) (subject to amendment on NSWPSA approved amount)
Please note: All payment receipts and confirmations will be reviewed and verified before approval is given for reimbursement.
Itemised Tax Invoice

Cancelof
Training Seminar/Course Invoice/receipts

Cancelof
Travel & Accommodation

Cancelof
I declare that all information, documents and payment confirmations contained in this reimbursement application are true and correct.
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