NVWF TREASURER’S FORM
CLUB NAME: __________________________________________________________________________________
Choose Request: 1) Deposit to NVWF 2) Check from NVWF
Amount: ____________________________________________________________________________
Reason: _____________________________________________________________________________________
FOR CHECK REQUESTS:
(include copies of contracts or receipts)
Payable to: _____________________________________________________________________________________
Date: _________________________________________________________________________________________
Mailing Address: ________________________________________________________________________________
Contact Name & Phone Number: ____________________________________________________________________
Send this form;
1) alone with your club’s registration check for deposit* …OR FOR
2) reimbursable with receipt, 3) $750.00 Host Fee two weeks before your meet date, and
a separate form for 4) the $300.00 athletic trainer fee to:
NVWF Treasurer
c/o James Zoller
6329 Bob White Drive
Warrenton, VA 20187
(*This form is used to send or request monies only, do not send with Registration Forms.)
