Please refer to this document for the AGF expense policy and allowable mileage.

AGF Expense Claim Form Appendix F

Claimant*

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First name *

Last name *

×

Email *

Mobile

Address

City

Country Country Canada United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivarian Republic of Venezuela Bolivia Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Brazil British Indian Ocean Territory British Virgin Islands Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Cayman Islands Central African Republic Chad Chile Christmas Island Città del Vaticano Cocos (Keeling) Islands Colombia Comoros Congo Congo (DRC) Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Côte d’Ivoire Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong S.A.R. Hungary Iceland India Indonesia Iran Iraq Ireland Islamic Republic of Pakistan Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea Kosovo Kuwait Kyrgyzstan Lao P.D.R. Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R. Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands North Macedonia Norway Oman Palau Palestinian Authority Panama Papua New Guinea Paraguay People's Republic of China Peru Philippines Pitcairn Islands Poland Portugal Principality of Monaco Puerto Rico Qatar Romania Russia Rwanda Réunion Saint Barthélemy Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka St Helena, Ascension, Tristan da Cunha Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria São Tomé and Príncipe Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.A.E. U.S. Outlying Islands U.S. Virgin Islands Uganda Ukraine United Kingdom Uruguay Uzbekistan Vanuatu Vietnam Wallis and Futuna Yemen Zambia Zimbabwe Åland Islands 조선민주주의인민공화국

State/Province State/Province Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Québec Saskatchewan Yukon ALASKA ALABAMA ARKANSAS AMERICAN SAMOA ARIZONA CALIFORNIA COLORADO CONNECTICUT WASHINGTON, DISTRICT OF COLUMBIA DELAWARE FLORIDA FEDERATED STATES OF MICRONESIA GEORGIA GUAM HAWAII IOWA IDAHO ILLINOIS INDIANA KANSAS KENTUCKY LOUISIANA MASSACHUSETTS MARYLAND MAINE MARSHALL ISLANDS MICHIGAN MINNESOTA MISSOURI NORTHERN MARIANA ISLANDS MISSISSIPPI MONTANA NORTH CAROLINA NORTH DAKOTA NEBRASKA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEVADA NEW YORK OHIO OKLAHOMA OREGON PENNSYLVANIA PUERTO RICO PALAU RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VIRGINIA VIRGIN ISLANDS VERMONT WASHINGTON WISCONSIN WEST VIRGINIA WYOMING

Region

Zip/Postal code

Please select Program(s) that apply to your expense claim *

Acrobatic Gymnastics for All Men's Artistic Gymnastics Trampoline Gymnastics Women's Artistic Gymnastics NCCP Coach Developer AGF Board AGF Staff Demonstrator

Social Insurance Number (Canada)

Name / type of event / activity *

Name / type of event / activity

Date(s) *

×

+ Add

Location

Location

Expenses incurred

Please attach all receipts (use the upload button at the bottom of this form).

Personal vehicle

To be claimed by driver only; see mileage chart.

# of kms	Qty	$/km	Amount
Distance	Distance - Qty	$0.60
Subtotal $0.00

Please list passengers

Travel air/bus ($)

Travel air/bus ($)

Car rental/taxi ($)

Car rental/taxi ($)

Accomodation ($)

Accomodation ($)

Administration: telephone/mailing/other ($)

Administration: telephone/mailing/other ($)

Other Expenses Not Listed Amount ($)

Other Expenses Not Listed Amount ($)

Describe Other Expenses

Describe Other Expenses

Meals

Maximum of 75$/day.

Note: a meal cannot be claimed if the organizer or host provides a meal.

Meal	Qty	Price ($)	Amount
Breakfast	Breakfast - Qty	$17.00
Lunch	Lunch - Qty	$18.00
Dinner	Dinner - Qty	$40.00
Subtotal $0.00

Honorarium

# of sessions/hours/days	Qty	Rate ($)		Amount
# of sessions/hours/days 1	# of sessions/hours/days 1 - Qty	# of sessions/hours/days 1 - Rate ($)
# of sessions/hours/days	Qty	Rate ($)
+ Add item
Subtotal $0.00

Donation to a program

If you would like to make a donation to an AGF program, please indicate your choice and amount.

Men Women T&T Rec Athlete Coach Judge x Clear

Amount

Less donation ($)

Please type in a negative number.

Less donation ($)

Total payable to claimant ($)

Total

Payment Form *

Payment Form Cheque E-transfer

Cheque *

mail cheque hold cheque for pickup x Clear

Enter Email Address to Send E-transfer *

Enter Email Address to Send E-transfer

Upload receipts

Upload your receipts as images or PDF files.

Electronic signature*

Please sign your name inside the box

Draw Type

Signature pad ×

Type your name ×

Signature style Style 1 ▾

Style 1 Style 2 Style 3 Style 4 Style 5

Electronic signature Signature pad

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Please accept all conditions.

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Waitlist

  

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Respondent

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First name

Last name

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Email

Mobile

Participant

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Comment

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