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Co-production Payment Form
Lived In Payment Form
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Phone
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Preferred time of day to be contacted by phone, if any:
Are you a Coalition Member
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Co-production Activity
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How would you like to receive the payment?
Vouchers – please specify which company you would like the vouchers for
Payment into bank account – please provide bank details
Travel Expenses (If applicable)
Please note, all travel expenses will be a paid into your bank account. If you haven’t already provided us with your bank details, please provide them below:
Account Name
Bank
Account Number
Bank Sort Code
Please select from the list below:
Mileage
Taxi
Bus
Car Parking
Rail
Details of journey - From
Details of journey - To
Amount
Mileage will be paid at 45p per mile as per the government guidelines.
Please submit your receipts for Taxi/Bus/Rail and car parking expenses.
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Max. file size: 100 MB.
Please note, we aim to get your payment to you within 2 weeks of the event. Payments are made on the second and last Friday/Saturday of the month.
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I consent to Surrey Coalition of Disabled People storing and processing my personal information in order to manage and communicate with me regarding my application. For more information, please review our Privacy policy https://surreycoalition.org.uk/privacy-policy/
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Simple acts of kindness that can transform somebody's day to day life
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I've not been out for ages; it was really lovely to get out.
- Get More Active Get Together attendee
