Development objective (what long-term goal is this program/course intended to help you reach):
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If seeking a degree program, please attach a brief outline of the courses included in the program from the college catalog or program brochure (necessary for initial request only).
I understand that if this request is approved, reimbursement will be contingent upon successful completion (a grade of B or better for graduate courses; a grade of C or better for undergraduate courses) of each course and submission of all receipts and paid bills within 30 days thereafter. I further understand that failure to successfully complete any course(s) will result in an obligation to repay [company name] the amount of tuition advanced.
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Employee Signature
[ ] Approved [ ] Not approved
Does this application meet the established guidelines of the educational assistance program policy? [ ] Yes [ ] No
Was this expense included in the department budget?
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Department manager signature
This request is [ ] Approved [ ] Not approved
Reason (if not approved): _____________________________________________________
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Human resources manager signature
Advance in the amount of $ ________________ is approved.
Expense should be charged to ________________________________________
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Accounting manager signature
Reimbursement in the amount of $ _______________________ is approved.
Expenses should be charged to: ____________________________________
Documentation of successful completion attached: [ ] Yes [ ] No
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Accounting manager signature