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State Street Caledonian Challenge
The Scottish Community Foundation
126 Canongate
Edinburgh EH8 8DD

Name of marshal: (please print)

Position held during Challenge Check point / or Water Stop:

Period of claim from what date:

Travel from: to:

Rail, airfares, and other public transport:

Car Mileage: (miles @ 36 pence per mile)

Subsistence:

Telephone:

Other expenses: (Please specify)

Total amount claimed: £

Please attach all tickets/receipts

I declare that the total expenditure claimed above was incurred solely on State Street Caledonian Challenge (Scottish Community Foundation) business:

Signature of claimant:

Address of claimant:

Official use only

Payment authorised by:

Date: