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Tuition Reimbursement Policy

All Company employees who qualify for benefits (-- hours/wk) are eligible to participate in the Company Tuition Reimbursement Program. Under this Program, eligible employees will have tuition costs reimbursed up to $ ____ in any twelve-month period. The Company will only provide this benefit for courses related to improving or expanding your job-related skills and reimbursement will be provided only if the grade received in the course is an A or a B [; the only exception to this rule is if a course is required to acquire or maintain a license, certificate, or other similar qualification and is offered only on a Pass/Fail basis]. Employees must receive approval for their course from their supervisor and the Human Resources Department prior to enrolling to be eligible for a reimbursement. If your employment at the Company ends within one year of the completion of the course for which a tuition reimbursement has been provided, the employee is required to refund the amount of the tuition reimbursement.


Tuition Reimbursement Request

I, ______________________, request that _________________________reimburse me in the amount of $ ______________, which is the tuition cost for enrolling in [name of course] at [name of institution], commencing on _____________________________. __ I understand that I must receive an A or a B in the course to receive a tuition reimbursement. __ The course is required for me to become/remain licensed/certified in my field; the co only offered on a Pass/Fail basis. I understand that if my employment with [Company] ends within one year following the completion of this course, I must pay the amount of the tuition benefit received back to [Company]. By signing this Request, I am authorizing [Company] to deduct up $_____ from my last pay check to defray a portion o amount owed. By signing this Request, I am also promising to re-pay [Company] for any outstanding tuition reimbursement owed within six (6) months of leaving [Company]'s employ. The exact amount that I owe appears below. My signature indicates that I acknowledge that is the amount I owe. I understand that my obligation to [Company] for the tuition reimbursement is enforceable in a court of law Approved: Approved: ______________________ Supervisor ______________________ HR Date Date ________________ ________________ _________

Agreed and acknowledged by:

_______________________________ Date Student _________

I owe [Company] $ ._____________ Date



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