Expenses Claim

Form for ARCHERY SA Officers, Officials, State Team members & others seeking reimbursement for APPROVED expenses.

Claimant*
First name Surname
Email*
Enter Email Confirm Email
Contact Phone*
Membership Number*
Please enter a number greater than or equal to 0001.
Must be a currently financial member
Details of Expenditure
This Expenses Claim is for....*
- Select All
- Travel costs
- Accommodation
- Other
Date of Expenditure*
MM slash DD slash YYYY
Nature of Expenditure*
Details of expenses (receipts/proof of expenditure are required - you can attach electronic copies of receipts/invoices to this claim - see below)
Amount*
insert number and it will convert to $
Additional Expenditure
Date of Additional Expenditure
MM slash DD slash YYYY
Nature of Additional Expenditure
Details of expenses (receipts/proof of expenditure are required)
Amount
insert number and it will convert to $
Date of Additional Expenditure
MM slash DD slash YYYY
Nature of Additional Expenditure
Details of expenses (receipts/proof of expenditure are required)
Amount
insert number and it will convert to $
TOTAL AMOUNT OF THIS CLAIM*
insert number and it will convert to $ (If you have more claims than this form permits, you will need to complete another form.)
YOUR account details
Account Name (payee)*
BSB Number*

no spaces or hyphens (max 6 characters)
Account Number*
CAPTCHA
Proof of Expenditure*
Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.
You must attach copies of any relevant receipts, invoices or other proof of expenditure

Details of Expenditure