Expense Claim Form

HopOn Instructors

MCA Instructor

You will receive a confirmation by email.

First name *

Last name *

Email *

Mobile

Project *

Date(s) Worked

+ Add

Hours Worked

Please provide the hours you worked below.
(Note: QTY = total hours worked for that shift)

Example:
8:00 pm - 1:00 pm (Shift) --> 5 (QTY) --> $20.00 ($/Wage)

Shift (start-finish)

Qty

$/Wage

Amount

Subtotal $0.00

Additional Expenses

Mileage

If you are claiming mileage for multiple days, please record each trip separately (mileage there and mileage back for each day)

Mileage

Qty

$/km

Amount

Distance

$0.45

Distance

$0.45

Distance

$0.45

Distance

$0.45

Subtotal $0.00

Details (e.g. WPG to/from Niverville x2)

Other expense items

Expense

Qty

Price ($)

Amount

Meals

Equipment

Other

Subtotal $0.00

Details for "other"

Sum of expenses ($)

Upload receipts *

Upload your receipts as images or PDF files.

Electronic signature*

I confirm that the information provided is accurate.