OC LOCAL CHAPTER POST EVENT FORM
This form should only be used by OC local chapters who have already been APPROVED by the OC office to receive reimbursement.

The form must be completed post-event in order for your chapter to be reimbursed. Please submit this form and then email copies of your receipts AND your registration/attendee list from the event to expenses@obesitynetwork.ca and christensen@obesitynetwork.ca. We highly encourage the chapter to keep a copy of both the receipts and this form before mailing. Please note it can take up to six (6) weeks to process reimbursements.

**Original receipts must be mailed to the OC office at:

Obesity Canada
2-126 Li Ka Shing Centre for Health
University of Alberta
8602-112 Street
Edmonton, AB T6G 2E1

Attn: Expenses

Email address *
Obesity Canada Local Chapter Name *
Your answer
Your name *
Your answer
What is your role in the chapter? *
Your answer
What is your email? *
Your answer
EVENT INFORMATION
What was the name of your event? *
Your answer
What was the date of your event? *
MM
/
DD
/
YYYY
What type of event was this? *
Was there a registration fee for this event? *
If yes, what was the amount of the registration fee?
Your answer
What was the total amount collected from the registration fees? *
If no fees were collected, please enter "0"
Your answer
What was the total number of people in attendance at this event? *
Your answer
How was this event promoted? *
Social media, website, flyers etc.
Your answer
SPONSORSHIP
Did you receive any type of sponsorship for this event (not including OC local chapter grants)? *
If yes, what form of sponsorship did you receive?
If you did receive sponsorship, who were your sponsors?
Your answer
VENUE INFORMATION (Claim amounts here for REIMBURSEMENT)
What was the total cost for the venue? *
If there was no cost, please enter "0."
Your answer
Were food and beverages served? *
What was the total cost for the food and beverages? *
If there was no cost, please enter "0."
Your answer
SPEAKERS
Did you have speakers at this event? *
Was there a fee for the speakers? *
What was the total cost for the speakers? *
If there was no cost, please enter "0."
Your answer
Please list the speaker names.
Your answer
Please provide a brief description & evaluation of the event. *
Please include ~100 words description of your event and attach photos so that we can include these in our OC-SNP monthly newsletter. Please also let us know if there are things you would change, and ideas/dates for future events at your chapter.
Your answer
Please provide a name and mailing address for the cheque. *
Your answer
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