LOS ANGELES UNIFIED SCHOOL DISTRICT CAREER LADDER TUITION REIMBURSEMENT REQUEST REQUIREMENTS 1. 2. 3. 4. 5. Reimbursement is made only for classes for which a grade of A, B, C, or credit is received. An On-Campus Advisement Form must be submitted if Cumulative GPA is below 2.75. Reimbursement is not made to those who have already received educational assistance from any other District program during the current school year. Reimbursement is made based on participant's Ladder Level with one exception: community college courses taken when a participant is at Ladder Level 3, 4, or 5 will be reimbursed at Level 2 amounts. Below are the deadlines for submission of tuition reimbursement requests and all paperwork:
MONTHLY TERMS September, October, November December, January, February March, April, May June, July, August QUARTER/SEMESTER TERMS Fall
Winter
ALL PAPERWORK DUE March 31 May 31 September 30 December 31
Spring
Summer
*All requests must be submitted within 6 months of taking the class or test
INSTRUCTIONS
1.
All information must be completed. Use a separate form for: each term for which reimbursement is requested courses from different colleges or universities Arrange for an OFFICIAL TRANSCRIPT to be sent from the college or university attended which includes the final grades for all courses for which reimbursement is requested. It is advisable to request a receipt from the college or university that indicates when the transcripts were ordered. Grade reports and unofficial transcripts are not acceptable. Unofficial transcripts will only be accepted if signed by Career Ladder On-Campus Advisers from CSUDH, CSULA, CSULB, and CSUN. Send the Tuition Reimbursement request form, advisement form and transcripts to:
Career Ladder Office Los Angeles Unified School District 333 South Beaudry Avenue, 14th floor Los Angeles, CA 90017
2.
3.
For questions regarding tuition reimbursement, please call the Career Ladder Office at (213) 241-4571 **Please allow 2 - 4 weeks for processing after all documents have been received**
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TUITION REIMBURSEMENT REQUEST PLEASE PRINT OR TYPE
SECTION I. GENERAL INFORMATION
Last Name________________________________First____________ Address_________________________________________________
Employee #:_____________ LAUSD Email:
City & Zip Code:____________________________________________ Cell Phone:_______________ Work Site:________________________________ Work Phone:____________
SECTION II. WHEN AND WHERE COURSES WERE TAKEN (Use a separate form for each school and each term.)
College or University: ______________________________________________________________
Term:
SECTION III.
Year:
CREDENTIAL GOAL
Transcripts: Attached Semester Quarter
Mailed Separately
Elementary
Secondary Special Ed.
CBEST
SECTION IV.
Children’s Center Permit
Subject Specialty (ie. MMD)
Pupil Personnel Services Psychologist Date B.A. Counselor
Completed
CSET
RICA
BCLAD
Language
OFFICE USE ONLY GRADE Approved Approved Approved Approved Disapproved Disapproved Disapproved Disapproved COURSE # UNITS
COURSES FOR WHICH REIMBURSEMENT IS REQUESTED
COURSE NAME
1. 2. 3. 4.
The classes listed above are requirements for a bachelor’s degree and/or a teaching credential. I received a grade of C or better in each class. I understand that if, within six months of receiving reimbursement, I terminate employment with the District, I must repay the amount of reimbursement. I also understand that, upon completion of the Career Ladder, I must work as a teacher for the District for two years if offered a position or repay the amount of reimbursement received while a participant in the program.
Participant’s Signature Date
PA: 1
2 3 4
LADDER LEVEL ______
FOR OFFICE USE ONLY
UNITS APPROVED Semester _____ Quarter_____ ______ ______ ______ ______ ______
Verified by ___________ Date _________
APPLICATION DATE:____________________ Tuition Reimbursement Effective: Winter Spring Summer Fall
UNITS DISAPPROVED
Transcript: Not Official / Not Submitted Course(s) not on transcript Grade below C Received after deadline (___/___/___) Non Credential Course (Level 5) Courses prior to effective date Receiving other District Support Hired as a teacher (date) ___/___/___
Revised 06/08 SS
$_____________RATE
Hold for Advisement: _____Other Dist. Support____ S / Q Units__________ GPA_________ Cert / Class Classcode Paycode
$____________ REIMBURSEMENT
______ ______ ______
-
Authorized by _________ Date _________