LSC Supported Coach Training

LSC Supported Coach Training

Reimbursement Request
Contact Information

Please provide contact information for the person making the request.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Training Information
Name of Training*
Training Provider*
Date Prior Approval was Granted by the Executive Committee*

MonthDayYear
Date
Expenses
Only actual expenses are reimbursable. The reimbursement amount equals up to half of the actual expenses for each coach. The maximum support from the LSC for each coach is $500. Begining September 1, 2024, the maximum support to any one club during a fiscal year is $2,000.

Expense Summary*

	Coach's Name	$ Paid by Club	$ to be Reimbursed (max $500 per coach)
1
2
3
4
5
6
7
8
9
10

Total Reimbursement Request
Calculated Field
Documentation*

Upload proof of all expenses for each coach. A single pdf of all receipts, etc. is preferred.
Cancelof
Remittance

Please provide to whom to remit reimbursement.
Make Check Payable to:*
Send Check to:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Check if the address has changed since the start of this fiscal year (September 1)

The address listed above is a new address.
By signing below, you attest that all information provided is true and accurate. In addition, your request is in accordance with the Bylaws and Policies and Procedures of Niagara Swimming, Inc.
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Name of Signer*

First NameLast Name
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Contact Information