{"id":2343,"date":"2021-01-04T12:31:59","date_gmt":"2021-01-04T17:31:59","guid":{"rendered":"http:\/\/www.tcemf.org\/wps\/?page_id=2343"},"modified":"2024-02-14T16:49:43","modified_gmt":"2024-02-14T21:49:43","slug":"reimbursementform","status":"publish","type":"page","link":"http:\/\/www.tcemf.org\/wps\/reimbursementform\/","title":{"rendered":"TCEMF Reimbursement Form"},"content":{"rendered":"\n<div class=\"wp-block-contact-form-7-contact-form-selector\">\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f2342-o1\" lang=\"en-CA\" dir=\"ltr\" data-wpcf7-id=\"2342\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/wps\/wp-json\/wp\/v2\/pages\/2343#wpcf7-f2342-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"2342\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.3\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_CA\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f2342-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/><input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/fieldset>\n<p><label> Your name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"claimant-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" autocomplete=\"name\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"claimant-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> Your email<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"claimant-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" autocomplete=\"email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"claimant-email\" \/><\/span> <\/label>\n<\/p>\n<p><label> Name of Payee<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"payee-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"payee-name\" \/><\/span> <\/label>\n<\/p>\n<p><label> Total Amount claimed (tax included)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"claimant-amt\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number\" aria-required=\"true\" aria-invalid=\"false\" value=\"0.00\" type=\"number\" name=\"claimant-amt\" \/><\/span> <\/label>\n<\/p>\n<p><label> Preferred Method of Payment<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"payment-method\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"payment-method\"><option value=\"E-transfer\">E-transfer<\/option><option value=\"Paypal\">Paypal<\/option><option value=\"Cheque\">Cheque<\/option><\/select><\/span> <\/label>\n<\/p>\n<p><label> Payment Address<br \/>\nFor E-transfer or Paypal, please enter email address.<br \/>\nFor Cheque, please enter mailing address.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"payment-address\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"email\/mailing address\" name=\"payment-address\"><\/textarea><\/span> <\/label><br \/>\n------------------------------------------------------------------------\n<\/p>\n<p><label> Item 1 Description<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"item1-desc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"item1-desc\" \/><\/span> <\/label>\n<\/p>\n<p><label> Item 1 Amount (tax included)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"item1-amt\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"item1-amt\" \/><\/span> <\/label>\n<\/p>\n<p><label> Item 1 Department<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Item1Department\"><select class=\"wpcf7-form-control wpcf7-select wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"Item1Department\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Chair\">Chair<\/option><option value=\"ESCM\">ESCM<\/option><option value=\"Evangelism\">Evangelism<\/option><option value=\"Finance\">Finance<\/option><option value=\"Members Relationship\">Members Relationship<\/option><option value=\"Revival Meeting\">Revival Meeting<\/option><option value=\"Secretary\">Secretary<\/option><\/select><\/span><br \/>\n<\/label>\n<\/p>\n<p>------------------------------------------------------------------------\n<\/p>\n<p><label> Item 2 Description<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"item2-desc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"item2-desc\" \/><\/span> <\/label>\n<\/p>\n<p><label> Item 2 Amount (tax included)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"item2-amt\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"item2-amt\" \/><\/span> <\/label>\n<\/p>\n<p><label> Item 2 Department<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Item2Department\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"Item2Department\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Chair\">Chair<\/option><option value=\"ESCM\">ESCM<\/option><option value=\"Evangelism\">Evangelism<\/option><option value=\"Finance\">Finance<\/option><option value=\"Members Relationship\">Members Relationship<\/option><option value=\"Revival Meeting\">Revival Meeting<\/option><option value=\"Secretary\">Secretary<\/option><\/select><\/span><br \/>\n<\/label>\n<\/p>\n<p>------------------------------------------------------------------------\n<\/p>\n<p><label> Item 3 Description<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"item3-desc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"item3-desc\" \/><\/span> <\/label>\n<\/p>\n<p><label> Item 3 Amount (tax included)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"item3-amt\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"item3-amt\" \/><\/span> <\/label>\n<\/p>\n<p><label> Item 3 Department<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Item3Department\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"Item3Department\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Chair\">Chair<\/option><option value=\"ESCM\">ESCM<\/option><option value=\"Evangelism\">Evangelism<\/option><option value=\"Finance\">Finance<\/option><option value=\"Members Relationship\">Members Relationship<\/option><option value=\"Revival Meeting\">Revival Meeting<\/option><option value=\"Secretary\">Secretary<\/option><\/select><\/span><br \/>\n<\/label>\n<\/p>\n<p>------------------------------------------------------------------------\n<\/p>\n<p><label> Item 4 Description<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"item4-desc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"item4-desc\" \/><\/span> <\/label>\n<\/p>\n<p><label> Item 4 Amount (tax included)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"item4-amt\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"item4-amt\" \/><\/span> <\/label>\n<\/p>\n<p><label> Item 4 Department<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Item4Department\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"Item4Department\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Chair\">Chair<\/option><option value=\"ESCM\">ESCM<\/option><option value=\"Evangelism\">Evangelism<\/option><option value=\"Finance\">Finance<\/option><option value=\"Members Relationship\">Members Relationship<\/option><option value=\"Revival Meeting\">Revival Meeting<\/option><option value=\"Secretary\">Secretary<\/option><\/select><\/span><br \/>\n<\/label>\n<\/p>\n<p>------------------------------------------------------------------------\n<\/p>\n<p><label> Item 5 Description<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"item5-desc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"item5-desc\" \/><\/span> <\/label>\n<\/p>\n<p><label> Item 5 Amount (tax included)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"item5-amt\"><input class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-number\" aria-invalid=\"false\" value=\"\" type=\"number\" name=\"item5-amt\" \/><\/span> <\/label>\n<\/p>\n<p><label> Item 5 Department<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Item5Department\"><select class=\"wpcf7-form-control wpcf7-select\" aria-invalid=\"false\" name=\"Item5Department\"><option value=\"\">&#8212;Please choose an option&#8212;<\/option><option value=\"Chair\">Chair<\/option><option value=\"ESCM\">ESCM<\/option><option value=\"Evangelism\">Evangelism<\/option><option value=\"Finance\">Finance<\/option><option value=\"Members Relationship\">Members Relationship<\/option><option value=\"Revival Meeting\">Revival Meeting<\/option><option value=\"Secretary\">Secretary<\/option><\/select><\/span><br \/>\n<\/label>\n<\/p>\n<p>------------------------------------------------------------------------<br \/>\n<label> Receipt uploads (up to 5 receipts)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"Receiptsupload\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-drag-n-drop-file d-none\" aria-required=\"true\" aria-invalid=\"false\" type=\"file\" multiple=\"multiple\" data-name=\"Receiptsupload\" data-min=\"1\" data-max=\"5\" data-id=\"2342\" data-version=\"free version 1.3.9.2\" accept=\".\" \/><\/span><br \/>\n<\/label>\n<\/p>\n<p>------------------------------------------------------------------------<br \/>\n<input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/>\n<\/p><p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"_wpcf7_ak_\"><label>&#916;<textarea name=\"_wpcf7_ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"_wpcf7_ak_js\" value=\"201\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"class_list":["post-2343","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/P5z7Vx-BN","_links":{"self":[{"href":"http:\/\/www.tcemf.org\/wps\/wp-json\/wp\/v2\/pages\/2343","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.tcemf.org\/wps\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/www.tcemf.org\/wps\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/www.tcemf.org\/wps\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.tcemf.org\/wps\/wp-json\/wp\/v2\/comments?post=2343"}],"version-history":[{"count":5,"href":"http:\/\/www.tcemf.org\/wps\/wp-json\/wp\/v2\/pages\/2343\/revisions"}],"predecessor-version":[{"id":2717,"href":"http:\/\/www.tcemf.org\/wps\/wp-json\/wp\/v2\/pages\/2343\/revisions\/2717"}],"wp:attachment":[{"href":"http:\/\/www.tcemf.org\/wps\/wp-json\/wp\/v2\/media?parent=2343"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}