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To submit your expenses for reimbursement, please fill out the form below and attach all receipts/documentation. If you have more than five items to claim, you may fill out the form again.

If you have any questions, please contact Joanna Dawson at jdawson@canadashistory.ca.

* indicates required fields

Name

Mailing address

City

Province

Postal code

Phone

Are you submitting a claim for mileage reimbursement?

Yes

Starting address

Destination address

Total distance (round-trip)

Item 1 description

Item 1 date

Item 1 total

Item 2 description

Item 2 date

Item 2 total

Item 3 description

Item 3 date

Item 3 total

Item 4 description

Item 4 date

Item 4 total

Item 5 description

Item 5 date

Item 5 total

Upload a scan of all receipts

Please select a file

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Expense Reimbursement Form