TUITION REQUEST - Scott County
TUITION REQUEST
AND
REIMBURSEMENT FORM
Complete PART I at least 3 weeks prior to course registration.
I hereby acknowledge I have read and agree to terms of the County’s Tuition Reimbursement Program as stated in Policy E. I agree to reimburse the County in accordance with said policy should I voluntarily terminate within 2 years of completion of the course.
Employee Name Department/Position
Employee Signature__________________________ Date_________________________________________
|Course Title |Educational Institution |Course Date(s) |Description and Application to Job |
| | |Time(s) | |
| | | | |
| | | | |
| | | | |
|Estimated Cost: Tuition $______________ Books $________________ |
|County Share ( up to 75%) $_______________ Employee Share (25%) $________________ |
|APPROVED BY: |
|___________________________________________ ______________________________ |
|Human Resources Director – Approval Date |
| |
Complete PART II following completion of course and attach all receipts along with course grade(s)
|Tuition $ __________ |Amount Reimbursed to Employee: |
|Books $ __________ | |
|Total $ __________ |(50% or 75%) $ __________ |
| |(Circle appropriate % based on course grade) |
I CERTIFY THAT THE FOREGOING EXPENSES HAVE BEEN INCURRED IN THE ABOVE APPROVED COURSES.
Employee Date
-----------------------
PART I – TUITION REQUEST
PART II – REIMBURSEMENT REQUEST
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- pete davidson s father scott davidson
- scott davidson s daughter casey davidson
- scott davidson 911
- scott matthew davidson 9 11
- request baltimore county police report
- casey davidson s father scott davidson
- scott davidson firefighter
- scott davidson facebook
- scott davidson
- dr scott davidson
- scott davison
- scott davidson dds