School District of Philadelphia



THE SCHOOL DISTRICT OF PHILADELPHIA

CAREER DEVELOPMENT FUND PROGRAM

CRITERIA FOR TUITION REIMBURSEMENT

1. Appointed Secretary, School Operations Officer, Paraprofessional, Non-Teaching Assistant, and the Professional-Technical Unit.

2. Approved Long Term Substitute for period of approved long-term status.

(No summer unless there is previous approval, i.e., secretary.)

3. Must take college level courses at an accredited college or university. Video or correspondence courses will not be approved for reimbursement.

4. Must secure grades for college credit (“C” or above or “Pass” with qualifying statement of average or course status) as evidence of successful completion.

5. Collegiate grants or approved stipends granted by the collegiate institution will be deducted.

6. All courses must be related to the field of education or educational support fields.

7. Fees incurred for advanced credits granted by a university are not reimbursable. The program reimburses only for actual courses taken and completed during the academic time of Spring 2013 though Fall 2013 with a passing grade of “C” or better.

8. No payment is made for a transcript evaluation, books, and other fees charged by the university.

9. Practicum or field experience must be taken outside of applicant’s regular working hours unless on approved leave of absence or sabbatical leave.

THE SCHOOL DISTRICT OF PHILADELPHIA

APPLICATION FOR TUITION REIMBURSEMENT

Spring 2013 though Fall 2013

Employee Name:______________________________ EIDN: __________________________

Home Address: _______________________________ Home Telephone: ___________________

_____________________________________________ Work Location Name: _______________________

City

Work Location Number: _____________________

____________________________________________

State Zip Work Telephone: ___________________________

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Job Classification, Check One:

Secretary ___ Paraprofessional ___ NTA ___ Prof-Technical ___ School Operations Officer ___ Other ___

Eligibility: Tuition reimbursement is provided for secretaries, school operation officers, paraprofessionals, non-teaching assistants, and staff from the professional-technical bargaining unit in the Agreement between The School District of Philadelphia and the Philadelphia Federation of Teachers, Local 3, American Federation of Teachers AFL-CIO. (Sec.XIII.H.1-4)Reimbursement is not given for tuition covered by grants received from another program.

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Current Enrollment: List all completed courses. Check one: Associate Degree ____ Undergraduate ____

|Course Title and Number | | 2013 Semester |Tuition Per Credit | |

| |Name of College University |Spring Summer Fall |Hour |Total Credits |

| | | | | | | |

| | | | | | | |

| | | | | | | |

| | | | | | | |

| | | | | | | |

Amount of Tuition Reimbursement Requested $ ____________________________

Amount of Grants Received from Other Sources $ ___________________________

Matriculated Student: Yes___________ No ___________

I hereby acknowledge that the information listed above is accurate.

Date:____________________ Applicants Signature______________________________________________

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For Office Use Only

____ Approved ____ Disapproved Total ________________________

Reviewed by _________________________ Signature ________________________________ Date ________

THE SCHOOL DISTRICT OF PHILADELPHIA

Authorization to Release Financial Aid Information

PART II MUST BE COMPLETED BY THE COLLEGE/UNIVERSITY

EVEN IF YOU DID NOT RECEIVE FINANCIAL AID

PART I.

TO: Financial Aid Office of __________________________________________________________

(Name of College/University)

I hereby give you permission to release information to The School District of Philadelphia regarding financial aid that I have received, or am receiving, to be included with my application for tuition reimbursement for the period of 1/01/13 through 12/31/13. This certification is necessary whether you have or have not receive any financial aid and must be signed by the college or university official in order to have your application processed.

______________________________________________ _____________________________________________

Last Name First Name Maiden Job Title

______________________________________________ _____________________________________________

Address School/Office

______________________________________________ _____________________________________________

City State Zip School/Office Phone Home Phone

______________________________________________ _____________________________________________

Employee Identification Number (EIDN) Students Signature

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PART II.

TO: The College/University – Please complete this portion and return to Ms. Deborah Schultz, The School District of

Philadelphia, Education Center, 440 North Broad Street, (Portal D) Suite 222, Philadelphia, PA 19130.

The above-named student did _______ did not ______ receive financial aid.

Spring 2013 Summer 2013 Fall 2013

GRANTS: Pell Grant ________________ ________________ ________________

PHEAA ________________ ________________ ________________

SEOG ________________ ________________ ________________

TOTAL GRANTS ________________ ________________ ________________

LOANS: Guaranteed Student Loan ________________ ________________ ________________

National Direct Student ________________ ________________ ________________

College University ___________________________________________________ Phone No:______________________

Signature______________________________________________ Title ____________________ Date ______________

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