You can either print and complete this page or CLICK HERE for a PDF version of this claim form.
Details on completing this form are found below.

Name _______________________________________________________________________
Address __________________________________ City ____________ Postal Code _______            
Phone   ____________________   ­­­­­E­mail  ___________________________________________­­­­

 
Use travel policy below on following page to calculate claim.

Date	Game location From and To (indicate if you worked 1 or 2 games)	Driver or Passenger	Amount
Signature of Claimant ________________________________		TOTAL  $

Soccer Nova Scotia use only:  
*All referee travel expense forms are to be sent to assignor@soccerns.ca*
 

---

NSSL Travel Policy for the 2018 Outdoor Season

All travel claims will be paid by the League – the form is posted on the NSSL website

For claim purposes, assigning regions are Cape Breton, Highland, HRM, Valley and South Shore
 
Travel for games played to June 30, 2018 in the same region will be paid by the league at the rate in place in your region.
 
Travel for games played to June 30, 2018 for travel between regions will be paid by the league at the same rate as the SNS in 2018.
 
Travel for all games played after July 1, 2018 will be paid by the league as per the following schedule.
 
 
Notes for Referees
 
1.  If you pick up a game on up for grabs - no travel will be paid
 
2.  Claims should be submitted to assignor@soccerns.ca – the form can be found on the league website http://nssoccerleague.ca/
 
3.  To control costs, Referees will be asked to travel together.  The Assignor will designate a driver.   In the event the passenger wishes to take their own car, they will receive the passenger travel compensation.   Designated drivers, who do not wish to take passengers, will be paid the passenger rate and another designated driver appointed.
See schedule at the end of this paper.
 
Notes for Assignors

Assignors who will need referees from another region should submit their request 10 days in advance so the league assignor can manage the request.
 
If an Official travels for a NSSL game and also does a game in the local league – travel costs should be paid by the local league and the league will bill the NSSL for 50% of the NSSL travel fee as per the following schedule.
 
Assignors are asked to exercise the same due diligence they do for their local leagues to assign keeping travel costs at a minimum.


RATES 
 

		Mileage, Meals & Incidentals                                  1 game		Mileage, Meals & Incidentals                                   2 games
		Driver	Passenger	Driver	Passenger
Antigonish	Pictou Co	35	10	60	35
Colchester	Pictou Co	35	10	60	35
Middleton	Valley	35	10	60	35
HRM	Valley	60	10	85	35
Middleton	S Shore	60	10	85	35
Colchester	HRM	60	10	85	35
HRM	S Shore	60	10	85	35
Valley	S Shore	60	10	85	35
Antigonish	Colchester	60	10	85	35
HRM	Pictou Co	125	35	140	50
Antigonish	Cape Breton	145	50	160	65
Antigonish	HRM	165	50	160	65
Pictou Co	Valley	165	50	160	65
CapeBreton	Pictou Co	185	75	185	75
Antigonish	Valley	210	75	200	75
CapeBreton	Colchester	225	80	225	80
Antigonish	Middleton	245	80	245	80
CapeBreton	HRM (over night)**	330	145	320	160
CapeBreton	Valley (over night) **	365	150	355	180
CapeBreton	Middleton (over night) **	400	155	390	180
East Hants		25
Porters Lake		21

 ** Breakfast & hotel TBD

It is not anticipated that there will be travel for the following in the immediate future:
 

From...	To...
Antigonish	S Shore	x
Antigonish	Yarmouth	x
CapeBreton	S Shore	x
CapeBreton	Yarmouth	x
Colchester	Middleton	x
Colchester	S Shore	x
Colchester	Valley	x
Colchester	Yarmouth	x
HRM	Middleton	x
HRM	Yarmouth	x
Middleton	Pictou Co	x
Middleton	Yarmouth	x
Pictou Co	S Shore	x
Pictou Co	Yarmouth	x
Valley	Yarmouth	x
Yarmouth	S Shore	x