APPLICATION FOR TUITION ASSISTANCE TO ATTEND CLASS OR SEMINAR by zCcBpI7

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									Revised: 10/2011
                          APPLICATION FOR TUITION ASSISTANCE TO ATTEND CLASS OR SEMINAR
                                                Wichita State University


Name:                                                                                          myWSU #
Position Title:
Office Phone No.:                                                                                Campus Box No.:
Department or Unit:                                                                         Semester Applying For:
Please provide the following information to assist in determining your eligibility for assistance.
        1.   Are you:                                      Unclassified Professional Non-Teaching or                        Classified
             (Note: Employees whose primary duty is instruction are not eligible for this assistance.)

        2.   Do you earn vacation and/or sick leave hours?                                                       No              Yes
        3.   Do you work twenty (20) or more hours per week?                                                     No              Yes
        4.   Are you currently receiving financial aid?                                                          No              Yes
             If yes, what type of aid are you receiving?
        5.   Have you received tuition assistance from this program in the past?                                 No              Yes
             If yes, Semester & Year of prior tuition assistance:
             Grade expected or at completion (if class):
Please complete Box #1 for Course/Workshop or Box #2 for Seminar:

#1 Title of Course/Workshop:                                                                           Credit Hours:
Credit Level Sought is:           Graduate                 Undergraduate
Subject & Course No. (i.e. ENGL 102):                                  Course Reference No. (i.e. 22299):
Anticipated Cost of Tuition:
Lab Fees and Special Course Fees:
Date Course/Workshop begins:                                                                  Time to be held:



#2 Title of Seminar:                                                                              Anticipated Cost:
Department Sponsoring Seminar (CMD, Continuing Ed, etc.):
Date(s) to be held:                                                                               Time to be held:


The signatures below certify that the employee authorizes access to their transcript to the Human
Resources representative and the application fits at least one of the following criteria:
                                                                    Credit towards a degree:                           No        Yes
                                                                    Professional growth or development:                No        Yes
                                                                    Job-related training:                              No        Yes
Signatures required:
Employee:                                                               Supervisor:
                                                                     Budget Officer

                                 Return to Shelly at Campus Box 15 or Fax to ext. 3201.
For OHR Use Only:
Date last T.A. received: _____________                                                                     Approved: ______________
Grade: ______________                                                                                   Disapproved: ______________

								
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