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SCSA EXPENSE REIMBURSEMENT FORM
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NamePhone
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EmailDate Submitted
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DateDescription of Expense (ie: Days Inn hotel, one night)Amount (enter max $180/night for hotel and max $15/meal or $45/day)Details (ie: the team you coached, the tournament name, the reason for the expense or travel, etc)MILEAGE - DestinationKMAmountMark an 'x':
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$0.00 Head Coach (non-parent)
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$0.00 Assistant Coach (18+)
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$0.00 Junior Coach (14+)
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$0.00 Board Member
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$0.00 Refereee
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$0.00 Manager
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$0.00 Technical Director
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Total$0.00 Total Mileage - $0.00 Other
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** Email completed form and receipts to swiftcurrentsoccer@gmail.comTotal Reimbursement Due$0.00
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*Refer to the "Instruction tab" for submission deadlinesPer KM Reimbursement$0.45
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For SCSA use only:
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Approved by: Signature:*Hotel receipts must be submitted
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Payment method:Amount:
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Date Paid:House/United or General
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*Revised September 2, 2026
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