Fillable Tuition-waiver-form Tuition Reimbursement Form

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Tuition-waiver-form Tuition Reimbursement Form

On average this form takes 9 minutes to complete

The Tuition-waiver-form Tuition Reimbursement Form form is 1 page long and contains:

  • 2 signatures
  • 26 check-boxes
  • 17 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Eastern Florida State College

BROWSE EASTERN FLORIDA STATE COLLEGE FORMS

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TUITION WAIVER FORM
2-1-19
1. Complete all fields on this form when you register for EFSC courses. Use the Tab key to move from one field to the next.
2. Class registration is limited to 2 (two) classes or 7 (seven) credit hours per semester.
3. After registration, submit this completed and signed form to the HR/Tuition Program Office on Cocoa a minimum of 5 (five) days prior to
fee-due date to ensure timely processing.
4. HR will review for eligibility and, if approved, submit to Accounting; the waiver will be applied at that time.
Personal
Information
Name: Date: Term:
Date of hire:
Employee B number: B
Job Type
Job Category (choose most appropriate):
Full-time employee, non-faculty
Regular part-time employee, non-faculty
Full-time faculty
Part-time (adjunct) faculty
PT Faculty
If PT Faculty, mark your selection for the following:
Length of time teaching (select one):
6+ semester hours during previous academic year
Less than 6 semester hours/previous academic year
Teaching Schedule (select one):
Teaching at EFSC during time of course completion
Not teaching at EFSC during time of course completion
Course
Choice(s)
Number of Credit Hours: 1, 2, 3, 4, 5+
Course ID Number:
Course Description:
Number of Credit Hours: 1, 2, 3, 4, 5+
Course ID Number:
Course Description:
Number of Credit Hours: 1, 2, 3, 4, 5+
Course ID Number:
Course Description:
Tuition
Indicate tuition total: $
Employee Commitment
Please check each paragraph to indicate your understanding and agreement (all boxes must be checked):
I understand that if I receive a grant or scholarship after applying for a tuition waiver that this waiver will be applied only to the
extent that there is a remaining balance owed for tuition. EFSC tuition waivers will not result in refunds to the employee.
I understand that the College reserves the right to withhold tuition waivers when select balances are owed to the College by the
employee.
I understand that it is my responsibility to pay fees associated with the class(es) or my registration will be dropped.
By checking each box above and by signing below I agree to each of the items and I will submit this completed electronic form to the
HR/Tuition Program Office on Cocoa Campus, either by email to Tuition@easternflorida.edu
, by campus mail, or in person.
Agreement to above information: ___________________________________________________________
Signature
Supervisor
I acknowledge that I have been informed that the above-named employee will be attending class at EFSC, but not during the hours of
responsibility to the College.
_____________________________________________________ ________________________________________________
Supervisor signature Print name
HR
Review
Date Received:
HR Initials
AVP Initial:
HR Notes:
Instructions to Accounting
Amount to waive: $
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Tuition-waiver-form Tuition Reimbursement Form

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Completed 17 November 2019

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