Tuition Reimbursement Pre-Approval (Civil Service Employees)

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Tuition Reimbursement Pre-Approval (Civil Service)

Important! This form must be signed by your Supervisor and approved by the Human Resource Department at least 30 days prior to course start date. Forms submitted late will not be approved for tuition reimbursement.

1.	Employee's Name (Last, First, Middle Initial)

2.	Employee ID*

3.	Address, City, State, Zip Note: Fill in line only if your address has changed.

4.	Work Phone No.

5.	Work Location

6.	Employee Type
	Employee Type Clerical Technical Nutrition Services Custodial Other, please specify

7.	Course Title (submit one course per form)*

8.	Course Site*

9.	Course Number*

10.	Number of Credits (if applicable)

11.	Starting Date*
	mm/dd/yyyy

12.	Ending Date*
	mm/dd/yyyy

13.	Tuition Cost (excluding cost of books and supplies)* ($99,999,999)
	$

14.	Objective for Taking Course (be specific)*

	Please send a copy of the Course Brochure, Syllabus, or College Catalog to:

15.	Employee's Email Address*

16.	Date Submitted*
	mm/dd/yyyy

17.	Supervisor's Email Address* Your Supervisor’s approval is needed before submitting this request to the Human Resource Department. Please print out a copy of this form for your records before submitting it. If you have questions about tuition reimbursement, contact Kelly Motz at kelly.motz@spps.org.

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