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Employee Tuition Reimbursement Request and Approval Form

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Employee Tuition Reimbursement Request and Approval Form Powered By Docstoc
					This form allows for an employee to request from their employer reimbursement of
tuition related to classes or courses taken that benefit the company. The employee
must list the course taken, provide a tuition breakdown, and describe how the courses
relate to the employee’s duties and responsibilities. This form is both a request to be
completed by the employee and an approval form to be used by the employer. The
appropriate company official then indicates whether the request is approved and for how
much. This form should be kept in the employer’s personnel records.
                     Employee Tuition Reimbursement
                           Request and Approval Form
 This request for tuition reimbursement is to be completed and must be approved prior to
                                    attending classes.

Date: __________________



Employee Name:                  ___________________________________________________

Employee ID:                    ___________________________________________________

Employee Job Title:             ___________________________________________________

Employee Department:            ___________________________________________________



Name of School or Program: ___________________________________________________

Name of Courses:                _______________________________ Dates: ______________

                                _______________________________ Dates: ______________

                                _______________________________ Dates: ______________

                                _______________________________ Dates: ______________

                                _______________________________ Dates: ______________

(If more than five (5) courses, please complete a second form)



Tuition Breakdown:              Per Credit: _________________ Total Credits: _____________



Total Reimbursement Amount Requested: ____________________




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Describe how each course listed above relates to your employment: _____________________

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© Copyright 2012 Docstoc Inc.                                                  3
This is a request for reimbursement of tuition fees related to courses that I intend to take to
further my abilities to perform my job duties.

I am seeking reimbursement of these tuition fees because the skills and knowledge that I
will learn as a result of participating in these courses will benefit both my employer and
myself.

I agree to attend each course session in its entirety and to put forth my best efforts in
learning the subject matter and/or skills that are being taught. If a grade (whether a letter
grade or pass/fail or any other form of grading indication) is provided as a result of my
participation in any course identified above, I agree that any tuition reimbursement that is
approved and that I receive is contingent upon my receiving at least a verifiable passing
grade. For the purposes of this agreement, a passing grade shall be a “C” or its equivalent.

In the event that I do not complete any course identified above or I do not receive at least a
passing grade in any course I agree to return any tuition reimbursement that I have
received related to that course and I relieve my employer from all obligations to reimburse
any unpaid tuition relate
				
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Description: This form allows for an employee to request from their employer reimbursement of tuition related to classes or courses taken that benefit the company. The employee must list the course taken, provide a tuition breakdown, and describe how the courses relate to the employee’s duties and responsibilities. This form is both a request to be completed by the employee and an approval form to be used by the employer. The appropriate company official then indicates whether the request is approved and for how much. This form should be kept in the employer’s personnel records.