RSU Societies Membership Expense Request Form 23/24

Please ensure you complete all section of this form fully for your payment request to be considered.

In addition to this, please note, we cannot approve expenses that exceed the funds available in your society's account. If you would like an updated balance for your society, please email societies@roehampton.ac.uk

Data Protection Agreement

Data Protection Agreement I understand and agree with that the data collected within this form is being collected in my legitimate interest to process my payment request and that it will only be for this purpose and for no other reason or use. I further understand it will be retained by the Union for up to six years to comply with financial and HMRC regulations.
Your Society
Student ID Number
Your Name Your Name First Last
Your Email address:
Please confirm your email address:
Reason for Refund

Please provide the following details for your expenses:

1. The date the items were used
2. Which event/activity the items were used for
1. 2.
Please attach evidence as proof of payment

Attach Files
Your Bank Account Details:
Name as it appears on your bank account:
Bank Sort Code: (6 Digits)
Bank Account Number: (8 Digits)
Total amount being refunded: £ Pounds . Pence
I confirm that the above is a true and accurate record of expenses i have incurred and understand that any false claims may result in disciplinary action against me:

I confirm that the above is a true and accurate record of expenses i have incurred and understand that any false claims may result in disciplinary action against me: Yes No

RSU Societies Membership Expense Request Form 23/24

RSU Societies Membership Expense Request Form 23/24

Your Bank Account Details: