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  • CBL Player and Staff Reimbursement Form

  • Today's Date *
    MM
    /
    DD
    /
    YYYY
     
  • Name *
    First
    Last
     
  • Mailing Address *
    Street Address
    Address Line 2
    City
    State / Province / Region
    Zip / Postal Code
    Country
     
  • Email Address *
  • Phone *
    (###)
    -
    ###
    -
    ####
     
  • I am a: *
    CBL Player
    Staff memeber
    Volunteer
  • I am submitting a reimbursement for: *
    Paid registration fee
    An approved staff or volunteer expense
    An approved marketing, advertising, and/or business expense
    All staff, volunteer, and business expense reimbursements have to be approve by the CBL Corporate office.
  • Reimbursement Dollar Amount *
    i.e. $35.00
  • Who authorizes this reimbursement? *
    First
    Last
     
    If you are a player or staff member please provide the name of your CBL General Manager. If you are a General Manager please provide the name of your corporate officer.