Meet Your Street Claim Form

Reimbursement claim form for agreed Meet Your Street funding.

Please complete this form within 30 days after your event.

This form must be completed in one session.

Please ensure you have all necessary information and documentation ready before you begin, including:

proof of the bank account (any one of these: a deposit slip, a letter from the bank, or a bank statement showing the bank account number).

If you encounter any issues with the application form, please contact: funding@selwyn.govt.nz.

Activity:
Summary of activity: Please include any highlights of the gathering and/or any community connections made.
Number of participants:
Location of activity:
Date of activity:
What was the total spend? Overall Cost of Activity
Please give details of how the money was spent: Please reference how much you're claiming from this fund and outline how the money was used. Receipts are to be attached at the bottom of the form.

Bank Account Name:
Bank Account Number:
Please upload a proof of the bank account: Any of these: a deposit slip, a letter from the bank, or a bank statement showing the bank account number

Receipts At least one receipt is required for reimbursement.
Photos of Event As part of submitting your claim, Council also requires no less than one high resolution photo of the gathering.
Photo Agreement:	By checking this box the applicant agrees to Selwyn District Council using their photos for marketing purposes.

I agree that the information provided in this form is correct.

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