RESEARCH FOUNDATION EDUCATION ASSISTANCE PROGRAM
Session for which tuition reimbursement is requested
Fall (Year) Spring (Year) Summer (Year)
Winter
(Year)
Intersession
(Year)
Fall ____(Year) Spring ____(Year) Summer ____(Year) Winter ____(Year) Intersession ____(Year)
I am seeking reimbursement for the following course(s) I intend to register for this semester
Course Title 1. ____________________________________________________________________________________ # of credits ____________________
2. ____________________________________________________________________________________ # of credits ___________________
Name______________________________________________________________________________ Employee #
___________________
Date _____________
Address ____________________________________________________________________________________________________________________________
Telephone # _______________________________________________________________________ Email ________________________________________
College/Location Where Employed _________________________________________________ Department ___________________________________
Project Name (Primary Appt.) ________________________________________________________ Project # _____________________________________
Project Name (Secondary Appt.) ______________________________________________________ Project# ______________________________________
Principal Investigator/Project Director (s) ___________________________________________________________________________________________
CUNY College Attending ____________________________________________________________ Degree Program Undergrad _____ Graduate _____
Major _____________________________________________________________________________ Expected Date of Degree _________________________
This is my first request for tuition reimbursement from the Research Foundation Yes _____ No _____
If the answer is "No", my first request for tuition reimbursement was for courses in the following semester
Reimbursement is available up to 2 courses per academic year
I am a full-time/part-time A employee of the Research Foundation and have been employed continuously (without a break in service of
more than 30 days) for at least one year.
Signature __________________________________________________________________________________________ Date __________________________
I am the Principal Investigator/Project Director for the applicant and confirm that the course(s) for which tuition reimbursement is being
sought will not interfere with the employee’s work schedule.
Signature __________________________________________________________________________________________ Date __________________________
For job related courses I am the Principal Investigator/Project Director for the applicant and confirm that the course(s) for which
tuition reimbursement is being sought is job related.
Signature __________________________________________________________________________________________ Date __________________________
For Office Use Only
I have reviewed the above and have determined that the employee currently is in eligible employment status under the terms of the
Research Foundation Education Assistance Program.
Approved
Office of Human Resources ________________________________________________________________________ Date __________________________
None of the benefits or policies stated herein are intended to be contractual in nature. They do not confer any right or privilege , but are informational only. The Research
Foundation retains the absolute right to amend or terminate any benefits or policy at any time. This benefit is applicable to all employees of RFCUNY, except those employees
whose benefits and terms and conditions of employment are determined by collective bargaining.
RESEARCH FOUNDATION
of The City University of New York
230 West 41st Street
New York, NY 10036-7207
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