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Meet Your Street gathering claim form. It is essential that we receive this form with all receipts attached to enable reimbursement. (If you have more scanned files than we have upload buttons for below you will need to combine some of them).

As part of the Selwyn District Council’s evaluation of Meet Your Street, all small subsidy recipients are required to complete this form. Reimbursement is capped at $75.00 per gathering.

If preferred, you may download a printable copy [PDF, 58 KB] of the form.

Name of organisation or street:
Contact name:
Address:
Email:
Activity:
Location of activity:
Number of participants:
Date and time of activity:
Weather conditions:
Any comments? (optional)

Please give details of how the money was spent and include copies of your receipts. (Please include at least one file, you may include up to five. Files must be PDF or JPG format, and under 5mb in size.)

Receipts:

Bank account details (please attach a bank slip if possible):

Bank Slip:

Please type the lower-case letters shown below into the box (about the 'captcha')

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Please complete this form after your event, attach receipts or scan and email before 30 April 2018.

Send your claim by submitting this form or sending your printable/scanned form to meetyourstreet@selwyn.govt.nz or post to:

Community Development
Meet Your Street
Selwyn District Council
PO Box 90
Rolleston 7643

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