Return this completed form to: 104 Fairchild Hall | 1601 Vattier Street Office 785-532-6420 | Fax 785-532-7628
Manhattan, KS 66506-1104 Website ksu.edu/sfa
| Email finaid@ksu.edu
Employee’s Name (Last, First, MI) Employee ID or Wildcat ID
Department Name Department Address Employee’s K-State Email Address
Career level (sel. one):
☐Undergraduate
☐Gr
aduate
I plan to enroll in (# of):
____ credit hours for Fall 2019
____ credit hours for Spring 2020
____ credit hours for Summer 2020
☐Ve
terinary Medicine
I request assistance for the following semester(s):
☐Fall 2019
☐Spring 2020 (incl. January intersession)
☐Summer 2020 (incl. May or August intersession)
Eligibility Requirements
• An employee qualified to apply must be in a full-time (0.9 or above), benefits eligible position.
• Only Kansas State University employees are eligible for Employee Tuition Assistance (ETA).
• Applicants must meet all eligibility requirements for the entirety of the semester for which ETA is sought.
• An employee’s dependent or spouse may apply for the K-State Dependent/Spouse grant.
Information for this program can be found at
ksu.edu/sfa/ksuetb/dsg.html
Award Details
• The award is exclusively for courses taken through K-State and billed by K-State. ETA does not apply to courses taken
through and/or billed by a third party.
(note: if never having been enrolled/admitted prior please ensure to have an active student account)
• The maximum award amount will not exceed the value of 3 credit hours at the in-state, on-campus tuition rate per
semester. Tuition rates can be found at ksu.edu/finsvcs/cashiers/costs
• ETA covers tuition only. Any fees associated with a K-State course, e.g. campus fees, online course fees, other institutional
fees, etc. are the responsibility of the employee.
• If any part of the tuition costs are waived or sponsored by another entity, the amount of the ETA will reflect and equal the
amount of remaining tuition, up to 3 credit hours (not including any fees, etc.).
• Work release is not a part of the program and time away from work is solely dependent on an agreement made with the
employee’s supervisor or department head.
Application Details
• Additional details can be found at ksu.edu/hr/current-employees/benefits/tuition.html
• Applications will have to be turned in prior to the semester for which ETA is requested.
• Once the ETA award has been applied, it will be viewable in the employee’s Student Center in KSIS
.
(
KSIS Links
>
Student Center
>
Finances
>
View Financial Aid
)
By signing below, I confirm that I am a Kansas State University employee in a full-time (0.9 or above), benefits eligible position
and will remain employed throughout the semester(s) indicated above. I also acknowledge that I have read the terms outlined
above.
Signature of Kansas State University Employee (required) Date
Digital signatures are not accepted.
Department Certification
By signing below, I certify that the above listed individual is currently employed with Kansas State University in a full-time
(0.9 or above), benefits eligible position and is expected to remain employed throughout the semester(s) indicated above.
Signature of Department Head (required) Printed Name of Department Head (required) Date
Digital signatures are not accepted.
2019 - 2020
Employee Tuition Assistance Application
