Fillable Tuition Remission Qual Relative Oct2013 (California Lutheran University)

Fill Online, Printable, Fillable, Blank Tuition Remission Qual Relative Oct2013 (California Lutheran University) Form

Use Fill to complete blank online CALIFORNIA LUTHERAN UNIVERSITY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Tuition Remission Qual Relative Oct2013 (California Lutheran University)

On average this form takes 8 minutes to complete

The Tuition Remission Qual Relative Oct2013 (California Lutheran University) form is 1 page long and contains:

  • 0 signatures
  • 13 check-boxes
  • 25 other fields

Country of origin: US
File type: PDF

U.S.A. forms for California Lutheran University

BROWSE CALIFORNIA LUTHERAN UNIVERSITY FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Human Resources Department - 60 W Olsen Road #1100 - Thousand Oaks, CA 91360 - P: 805.493.3185 – F: 805.493.3655 Oct 2013
Application for Tuition Remission
Qualifying Relative
Submit this form and Proof of Relationship*
Please complete entire form and return to the HR Department at least two weeks in advance of each semester or term. Incomplete forms will not be accepted.
DEPENDENT STUDENT INFORMATION
STUDENT’S LAST NAME
FIRST NAME
MIDDLE INITIAL
DATE OF BIRTH
STUDENT’S STREET ADDRESS
CITY
STATE
ZIP
STUDENT’S EMAIL
CONTACT PHONE
STUDENT’S RELATIONSHIP TO EMPLOYEE*
IS STUDENT MARRIED?
IF SO, DATE OF MARRIAGE
*Acceptable proof of relationship includes marriage certificate, birth certificate, etc. For additional reference please refer to the Employee Handbook.
APPLICATION INFORMATION
ANSWER ALL THAT APPLY TO THIS APPLICATION
Yes No
Are you seeking your first Baccalaureate degree?
Yes No
Are you a regularly admitted student for the Undergraduate program?
PLEASE INDICATE WHICH PROGRAM YOU WILL ENROLL IN THIS TERM
Traditional Undergraduate program (semester based) with fewer than 140 attempted units to date
Bachelor’s Degree for Professionals program (quarter based) with fewer than 140 attempted units to date
Fifth-year Credential program with fewer than 36 attempted units to date
PLEASE INDICATE YOUR REGISTRATION DETAILS FOR THIS APPLICATION
FALL
WINTER
SPRING
SUMMER
ACADEMIC YEAR:
TOTAL UNITS:
PLEASE INDICATE YOUR CLASS STANDING FOR THIS TERM CHECKED ABOVE
FRESHMAN (0-29 UNITS)
SOPHOMORE (30-59 UNITS)
JUNIOR (60-89 UNITS)
SENIOR (90-124 UNITS)
5
TH
YEAR CREDITIAL
EMPLOYEE INFORMATION
EMPLOYEE’S LAST NAME
EMPLOYEE’S FIRST NAME
EMPLOYEE’S HIRE DATE
EMPLOYEE’S CLU ID #
EMPLOYEE’S DEPARTMENT / WORK EXTENSION
EMPLOYEE’S HOME PHONE
SIGNATURE
To the best of my knowledge, I certify that the above information is true and correct.
I have attached or have on file with Human Resources proof of relationship, including a copy of the Tax Return for parent of dependent child.
SIGNATURE OF QUALIFIED RELATIVE
DATE
SIGNATURE OF EMPLOYEE
DATE
Taxation of benefits offered under the Education Benefits Policy is determined by the Internal Revenue Code and is subject to change at any time.
For additional reference to the Educational Benefits policy please refer to the Employee Handbook (pages 34-39).
For HR office use only:
Eligible
Ineligible
FTE Status
Payroll Hours
Benefit
class(es) at
%
Tax Return Verified
HR Benefit Initials
AVP of Human Resources Signature
Date
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Tuition Remission Qual Relative Oct2013 (California Lutheran University)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 20 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document