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2. Date
   Date
4. Tuition Aid Policy Information
   Syracuse City offers tuition aid to full-time, non-probationary employees who wish to continue their education. Tuition aid requests must be for courses of study that are related to the employee’s position with the City and approval of tuition aid requests is subject to the availability of funds. Tuition aid request must be submitted for approval prior to the start date of the course(s) for which the employee is requesting tuition aid. Approved tuition aid requests will be paid to the requesting employee as provided in section 16.060 (c) of the Syracuse City Personnel Policies and Procedures Manual. Employees who receive tuition aid will be required to return any aid received if they terminate their employment with Syracuse City within one year after receipt of said tuition aid.
8. Employee Information
10. Name
11. Employee Number
13. Department
14. Job Title
16. Date of Hire
    Date of Hire
17. Supervisor
21. Course Information
23. Educational Institution
25. Course Number
27. Course Description
29. Estimated Tuition Expense
30. Copy of Any Related Receipts
32. Employee Signature

    1. Yes

    I hereby request approval for tuition aid as described. By checking yes, I am submitting my online signature.
33. Date
    Date
37. Approval

    1. Approved
    2. Unapproved
38. Approval Details
40. Approval Signatures
42. Supervisor
43. Date
    Date
45. Department Head
46. Date
    Date
48. City Administrator
49. Date
    Date
53. Tuition Aid Payment Information
    To Be Completed upon Employee's Completion of Courses
55. Were the courses for which tuition aid was requested completed with a “C” grade or better?

    1. Yes (Eligible for tuition and payment)
    2. Some
    3. No (Not eligible for tuition aid payment)

    A Copy of the Employee’s Transcript Must Be Attached
57. If More Than One Course Taken, Please Specify Which Were Completed
59. Courses Completed with a "C"
    If “Yes” above, please indicate which course(s) were completed with a “C” grade or better, the grade received in each course, and the related percentage of aid that the employee is eligible for each course (refer to section 16.060 (c) for reimbursement percentage).
61. Document Upload
65. For Human Resources Use Only
67. Has the employee received any other tuition aid during the current fiscal year?

    1. Yes
    2. No
68. Amount Received
70. Total Amount of Reimbursement for Which the Employee Is Eligible in the Current Fiscal Year
72. Total Amount of Reimbursement for Which the Employee Is Eligible on This Request
74. Total Amount of Reimbursement to Be Provided to the Employee
76. Date the Reimbursement Was Paid out to the Employee
    Date the Reimbursement Was Paid out to the Employee
78. Reimbursement Processed By
Leave This Blank:


80. 1. Receive an email copy of this form.
81. Email address

    This field is not part of the form submission.

82. Submit

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