Expense Reimbursement Form for
Fundraising Promotion and Education Program Incentive

The PEF program ended as planned, on March 31, 2012.

Please use this form if you have outstanding external marketing expenses to submit for reimbursement.

All forms must be submitted by or before May 31, 2012, after which time this form will no longer be available and no further reimbursement applications will be accepted.

For help with this form:

call 1-888-646-1820, Ext. 2
email: marketing@ontarioelectronicstewardship.ca

Applicant Information

1. Contact Information

First Name *This question is required.

Last Name *This question is required.

Title

Organization *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

Province *This question is required.

Postal Code *This question is required.

Country

Email Address *This question is required.

Phone Number *This question is required.

Fax Number

Mobile Phone

Website

2. Collection Event Number: *This question is required.

3. Event Date *This question is required.

calendar

Project Summary

4. Did the event take place as planned? *This question is required.

Please give event details, including number of people that attended *This question is required.

5. Please estimate amount of e-waste collected: *This question is required.

# of pallets:
# of gaylords:
# of roll-off bins:

6. Please list external marketing materials used and any additional notes and comments: *This question is required.

7. Amount of external marketing costs being submitted for reimbursement?

Please note--receipts and proof of payment must be attached below for reimbursements to be processed *This question is required.

Please note: Your regional representative will be in contact with you to complete a post-event summary.

8. Please attach invoices or receipts. You can upload up to 10 MB of the following files: gif, jpg, doc/docx, xls/xlsx, & pdf. *This question is required.

File: {{filename}} delete

9. Please attach copies of any print media advertising from publication. You can upload up to 10 MB of the following files: gif, jpg, doc/docx, xls/xlsx, & pdf

File: {{filename}} delete

10. Please attach copies of any print media advertising from publication. You can upload up to 10 MB of the following files: gif, jpg, doc/docx, xls/xlsx, & pdf

File: {{filename}} delete

11. Please attach copies of any print media advertising from publication. You can upload up to 10 MB of the following files: gif, jpg, doc/docx, xls/xlsx, & pdf

File: {{filename}} delete

12. Please attach copies of any print media advertising from publication. You can upload up to 10 MB of the following files: gif, jpg, doc/docx, xls/xlsx, & pdf

File: {{filename}} delete

13. Please attach copies of any print media advertising from publication. You can upload up to 10 MB of the following files: gif, jpg, doc/docx, xls/xlsx, & pdf

File: {{filename}} delete

Please click on the submit button below.

If your form is successfully transmitted,
you will be redirected to the OES Homepage.

Expense Reimbursement Form for Fundraising Promotion and Education Program Incentive

The PEF program ended as planned, on March 31, 2012.

Expense Reimbursement Form for
Fundraising Promotion and Education Program Incentive