AYSO Region 137 Reimbursement Request Form

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AYSO Region 137 Reimbursement Request Form

This form must be filled out in order to be reimbursed. You will be required to email our Treasurer with proof of purchase after submission. Once submitted, our Treasurer will be notified. If you have any questions, any inquiries can be sent to our Treasurer, Amanda Holyoak via email at treasurer@ayso137.net.

**Please allow 2-4 weeks from date of receipt for verification processing.

Make check payable to: *

Mailing address: *

Amount *

Purpose/Event *

Please describe the reason for this refund request.

Refund requested by: *

Name of the person making this refund request.

Email address of person requesting refund *

Provide your email address. If we have any questions, we need a way to get a hold of you. Make sure you type in a valid email address.

Final Step
After submitting this refund request, you will still have to email your proof of purchase to our Treasurer in order to get reimbursed. Send an email with your proof of purchase as an attachment to Amanda Holyoak at treasurer@ayso137.net. **Be sure to complete submission of this form as well.
*

I have read/acknowledged that after submitting this electronic refund request form, that I must send an email with proof of purchase/receipt in order for the refund request to be processed. I also understand that by not submitting proof of purchase/receipt that it can delay my refund request being processed. Without proof of purchase/receipt, AYSO Region 137 can deny your refund request.

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