Police Clearance Submission/Reimbursement Request (LaSalle Minor Hockey Association)

Police Clearance Submission/Reimbursement Request
Fill in this form ONLY for Police Clearance submissions and reimbursements. Please use the Course Reimbursement form for requesting reimbursements for any coaching courses that were taken.

Submitter Information

Address

Police Clearance

Receipt

Please be sure that your scanned receipt is legible to avoid delays in reimbursement AND/OR rejection of your submission.