YDA Reimbursement Request Form (we endeavour to pay reimbursements within 14 days but please allow 1 calendar month before chasing payment)

Student name:

Parent/guardian name:

YDAprogramme

SCP
ECP
SUP

Telephone number

email address:

CLAIM DETAILS

Travel:

Details (ie from - to)

Dates of travel

Method of transport

Train
Bus
Car

If car please provide TOTAL mileage

If additional students were transported please give names:

If residential intensive please give details: (ie whether student/s stayed at venue or traveled daily)

OTHER - NB the YDA is unable to make any reimbursements without a receipt or other proof of payment with the exception of car travel

Please provide full details for claims that are not travel

Receipts to follow

via post
via email to: ydafinance@swindondance.org.uk

Reimbursements are made by bank transfer. If we do not already hold your bank details please provide below.

PLEASE NOTE THAT BANK DETAILS ARE HELD ON FILE. ONLY COMPLETE SECTION BELOW IF YOUR DETAILS HAVE CHANGED

Have your bank details changed since your last payment?

yes
no

Bank name:

Account number:

Sort code

OFFICE USE ONLY - payment authorisation

Budget code:

All info correct (Y/N)

Pay immediately (Y/N) if not - when

Authorised by

Cheque number OR BAC reference

Date paid

Posted / Remit / M A Updated