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

Print 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

First Name^*
Last Name^*
Phone Number^*

Example: ###-###-####
Email Address^*

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

Address

Street Address^*
City/Town^*
Province^*
Postal Code^*

Police Clearance

Upload copy of police clearance^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf.
Maximum # Files: 1. Maximum File Size: 4MB.

Receipt

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

Upload police clearance receipt^*

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf.
Maximum # Files: 3. Maximum File Size: 4MB.

Human Validation

Check The Box ^*

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

OMHA Digital Network

Get Mobile!

Contact Us