Alabama A&M University Tuition Assistance Form for Employee, Dependents, Spouse
Office of Human Resources Rev. December 2015
Alabama Agricultural and Mechanical University
Office of Human Resources
Mailing Address: Human Resources, Alabama A&M University, Normal, AL 35762
Phone: 256.372.5835 Fax: 256.372.5881
Application for Tuition Assistance for Employee, Dependents, Spouse
Tuition Assistance and Educational Benefits is documented in the University Staff Handbook (2011), Section 6.4 and University
Faculty Handbook (2011), Section 5.9.
Employee Information
Name Banner ID#:
Date of Employment: Department:
Email: Telephone:
Application is for: Fall [ ] 20 Spring [ ] 20
Tuition Assistance for Employee
Under the procedure of the Alabama Agricultural and Mechanical University governing tuition assistance, I certify that I
am an active full-time permanent employee of the University and eligible for tuition assistance.
Employee Signature: Date:
I certify that this employee has my approval for the course listed above and that all work time lost due to class attendance
will be made up or charged to appropriate leave.
Immediate Supervisor: Date:
Tuition Assistance for Spouse and/or Dependents
List spouse and all dependents eligible for tuition assistance.
I certify that I am an active regular full-time employee of Alabama Agricultural and Mechanical University and that my
spouse and/or unmarried dependent children (under the age of 26 at the beginning of the semester for which a tuition
grant is awarded) are eligible for tuition assistance in accordance with University procedure.
Employee Signature: Date:
Office of Human Resources Approval
Signature: Date:
