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Tuition Aid Request

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.

   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

    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

* indicates a required field