Certification Refund Request 2022-2023 (BLOMHA)

Print Certification Refund Request 2022-2023

Certification Reimbursement Policy : BLOMHA will pay one half of your initial certification fee and pay the other half if you return to volunteer the following season. BLOMHA does not reimburse for Vulnerable Sector Screenings (police checks).

Reimbursement Details

Choose the certification(s) for reimbursement^*
Coaching - Any Level
Respect in Sports for Activity Leaders
Trainer's Course
Check All That Apply
Cost Applying For^*
First HalfSecond Half
Team(s) Volunteering With^*

Examples: U9 Stars or U9 Select or U9 MD
YOUR First and Last Name^*

NAME OF PERSON CHEQUE TO BE PAID TO
Street Address^*

ADDRESS WHERE CHEQUE TO BE MAILED
City^*
Postal Code^*
Email Address^*

Example: yo[email protected]. Your submission will be sent to this address.
Telephone Number^*

Example: ###-###-####

Receipts

All applicable receipts must be attached.

Paid Receipts ONLY^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf.
Maximum # Files: 4. Maximum File Size: 4MB.

I understand this is not an immediate reimbursement. I will receive a refund within one to two weeks. If I have not received payment by this time, I will then contact BLOMHA administration.

I agree to the terms and conditions stated above^*

Human Validation

Check The Box ^*

Certification Refund Request 2022-2023 (BLOMHA)

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