Scholarship Reimbursement Form
Instructions: Please read carefully
-Awards must be used within a 12-month period or funds will be voided
-Recipient must be a CDS Foothill Chapter member at the time funds are used
-Awards are non-transferable (except from parents to children under the age of 12)
-This form must be submitted with each reimbursement request
-Please submit a reimbursement request within 30 days of event (clinic, show etc.)
-Please provide receipt of expense/proof of payment to
foothillscds@gmail.com
when you submit this form.
-Incomplete forms or forms without proof of expense will not be reviewed
-Please note that some scholarships specify what that particular award is to be used for
-Please allow 30 days for reimbursement to be issued.
Please review the following approved AWARD UTILIZATION prior to submitting a reimbursement.
Show entries
Workshops
Clinics
Lessons
Equestrian educational lectures and events pertaining to dressage and horse care
USDF University Credits
Attending CDS annual meeting
Online dressage education
Please contact the scholarship committee at
foothillschaptercds@gmail.com
if you are unsure if a certain expense qualifies.
* Required
Name
*
Your answer
CDS number
*
Your answer
USDF number
*
Your answer
Phone number
*
Your answer
Email
*
Your answer
Address
*
Your answer
Name of scholarship being used for reimbursement
*
Your answer
Year scholarship was awarded
*
Applied end 2019, awards to be used in 2020 (now extended to April 15, 2021 due to Covid)
Applied end 2020, awards to be used in 2021
Scholarship reimbursement request amount
*
Your answer
Please describe what the funds were used for. Please email a receipt/proof of expense to
foothillschaptercds@gmail.com
when you submit this form.
*
Your answer
Please type your name as an electronic signature
*
Your answer
Parent/guardian electronic signature if applicant is less than 18 years of age
Your answer
Today's date
*
MM
/
DD
/
YYYY
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