To:
From:
Date:
Re:
This form is to be used for reimbursement of Professional Dues or Licensing Fees per policy number 3.4 as follows:
The University may pay/reimburse the professional dues or licensing fees of a University employee if said dues or
licensing fees are a requirement for the employee to perform the primary function of her or his position with the
university. Any request for payment or reimbursement must be supported, in writing, by the employee’s Budget
Office and Budget Review Officer, and approved by the appropriate Vice President. An explanation of how and/or
why the professional dues or licensing fees are a requirement for the employee to perform the primary function of
her/his position with the University must be included in any request for payment or reimbursement.
Show explanation below as stated in policy.
Amount for
Employee Description Reimbursement
Employee
Budget Officer
Budget Review Officer
Provost and Senior Vice President