Partner Portal

Swim School Partner Submission for Reimbursement

Please fill out all fields and upload documents for reimbursement.

Today's Date

Business Name

Contact Name

First

Last

Phone Number

Funding Payable to (Name on Check)

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

*ALL sections must be filled out in order to advance to the next section or be able to submit the form

Number of Children Served for this Submission Only

Date Lesson Started

Date Lesson Completed

Document Upload

In this section, please upload the following:

ECAS Lesson & Progression Report: Download Sample Template
Financial Need Documentation - (Accepted forms only: SNAP, WIC, 1040 Tax Return, Foster Child Placement documentation, or Medicaid)
Photo and/or Video (per child)
Invoice

Comments

The International Swimming Hall of Fame, Inc. is registered as a 501(c)(3) nonprofit organization, incorporated in the State of Florida.

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