Education Benefit Agreement
Employee Name: __________________________________________________________________
Semester: _____________________________________ Total # of Credit Hours: ______________
Typical Work Hours: _______________________________________________________________
Related to
Job
Performance
3 Credit Hour Max
(supervisor initial)
Time Will Be
Made Up by
Employee
(supervisor initial)
Lunch Hour
Will Be
Used
(supervisor initial)
** All class loads and schedules must conform to SUU Policy #8.2.1 http://www.suu.edu/pub/policies/pdf/PP821Education.pdf
List Employeeʼs Revised Work Schedule For Semester Affected by School Attendance:
I agree to abide by the revised work schedule as outlined for the above-named semester. If my school/work schedule
changes, I understand that my supervisor must be notified and a new agreement completed.
_______________________________
Date
_______________________________
Date
_______________________________
_____________________________________________________________!
Employee Signature! ! ! ! ! ! ! !
Approved:
____________________________________________________________!
Supervisor Signature! ! ! ! ! ! ! !
____________________________________________________________!
Assistant Vice President for Facilities Management
Date
