University of Guelph – Department of Athletics - Sports Club Program
Reimbursement Request Form – Appendix K
This form is to be used to reimburse someone for the pre-approved purchase of supplies, equipment or services, or for the payment of fees on behalf of the club.
DO NOT use this form for entertainment or travel-related expenses.
 
Sport Club: _____________________________________________________________
Requested by: ___________________ Phone: ______________ Date: _____________
(club officer)
Approved by: ________________________________________ Date: _____________
(sport club director)
CHARGE TO: Sports Club Funds
N
The University must have the telephone number for all reimbursements.
ame of person being reimbursed: ________________________
Address: _____________________________________________
City / Province / Postal Code: ____________________________
____________________________________________________
Phone #: _____________________________________________
University Employee: Yes No
Description & Purpose of Items Purchased or Services Acquired:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Amount Requested: $ ______________
Reimbursements require the ORIGINAL receipt showing what was purchased on what date, and from whom. The receipt must also be signed by the person being reimbursed.
(for office use only)
Approved by: ______________
Account Charged to: ________________________
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