4-H Ontario Travel Subsidy Request Form
Travel reimbursement approvals will be made on a first-come, first-serve basis by 4-H Ontario staff. Youth participants will be informed of approval amounts prior to attending the conference. Please note: submission of receipts/documentation is mandatory for 4-H Ontario to validate and process reimbursement following the experience. An expense form with documentation must be submitted within thirty (30) days of attending the experience. For full details of the policy and potential reimbursement allocations, see 4-HOntario.ca/about-4-h/policies/; search 4.2.1 in the search tool on that page and then scroll to O-M-13.
Participant Name
*
First Name
Last Name
Participant Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
4-H Association
*
Please Select
Algoma
Brant
Bruce
Carleton
Chatham-Kent
Dufferin
Dundas
Durham East
Durham West
Elgin
Essex
Frontenac
Glengarry
Grenville
Grey
Haldimand
Halton
Hamilton Wentworth
Hastings
Huron
Indigenous Communities
Kawartha Lakes Haliburton
Kenora
Lambton
Lanark
Leeds
Lennox Addington
Manitoulin
Middlesex
Niagara
Norfolk
Northumberland
Oxford
Parry Sound
Peel
Perth
Peterborough
Prescott
Prince Edward
Rainy River
Renfrew
Russell
Simcoe North
Simcoe South
Stormont
Sudbury
Temiskaming
Thunder Bay
Waterloo
Wellington
York
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone
Please enter a valid phone number.
Travel Subsidy Information
Total return travel distance from home to bus/venue?
*
Estimated cost of travel at time of registration?
*
Please note: 4-H Ontario's travel reimbursement for mileage is at $0.25/km
Outline (or upload information below) that demonstrates how you have determined the most economical means of travel. This could include websites researched, calls made, air travel estimates, etc.
*
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If required, please upload any supporting information that outlines how you determined the most economical means of travel.
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Outline how you plan to share the experience you have with others afterwards.
*
Agreement Statement:
*
I am not receiving additional financial support through my 4-H Association or other sources.
I am eligible to receive support from my 4-H Association
Please indicate the amount of support you are eligible to receive from other sources.
Submit
Should be Empty: