Fillable Form Annex E-1 - Obligation Request Form - 2015-2016 (Page 2 of 4) in pdf

MN National Guard Circular 621-5-1

Annex E-1

1 July 2015

(3)

(initial) Course(s) that earn continuing education units (CEUs) are not eligible for the E-STR

program if they are required to obtain or maintain professional licensure (these courses may be paid through

other funding sources). Reimbursement is authorized for some certificate program courses that earn CEUs if

they are academic in nature, not required to obtain or maintain professional licensure, and are conducted by an

accredited institution. The education services officer is the approval authority for certificate courses that earn

CEUs.

(4)

(initial) The maximum lifetime benefit I may receive under this program is equivalent to 144

semester hour credits/208 quarter hour credits. Additionally, I understand if my E-STR period expires during the

course/term, I am not eligible for reimbursement for that course/term.

(5)

(initial) For undergraduate coursework, I must achieve a grade of C or better, Pass or

Satisfactory. I understand the MNNG will not reimburse me for any course from which I withdraw or receive a

grade of C- or below.

(6)

(initial) For graduate coursework, I must achieve a grade of B or better. I understand that the

MNNG will not reimburse me for any course from which I withdraw or receive a grade of B- or lower.

b. I understand I will be eligible for reimbursement for the course upon completion, and if the grade

requirements outlined above are met.

E-4. REIMBURSEMENT PROCEDURES.

a. Annual Obligation Form.

(1)

(initial) I will read, sign and submit an obligation form (Annex E-1) annually to the education

services office NLT 45 days after the course/term start date.

(2)

(initial) I understand the annual obligation form is an estimate of tuition for each term during

the school year. The actual amount of reimbursement is dependent on the school, credits and terms attended.

The school year is summer session II 2015 through summer session I 2016.

(3)

(initial) I understand that failure to obligate will result in non-payment for that course/term.

b. Request for Reimbursement:

(1)

(initial) I understand I must submit the following forms and supporting documents to the

education services office within 90 days after the last official day of the term. If I am enrolled in an accelerated

program, where several terms are completed during the course of a normal semester/quarter schedule, I will

submit requests in groups corresponding with a normal semester/quarter. I will request payment no more than

once each semester: fall, winter, spring, summer session I and summer session II terms.

(initial) Payment Request Form (Annex E-2).

(initial) Grade Report.

(initial) Fee statement must clearly show the amount of tuition charged. My final fee

statement must include all other benefits paid, or pending payment, directly to the institution on my behalf (i.e.

CH 33/Post 9-11 GI Bill). If the fee statement does not clearly show the amount of tuition charged or other

federal payments, I will obtain a letter from the institution that includes this information and lists a point of

contact at the institution.

(initial) Direct deposit form. State payments are made via direct deposit using Minnesota

Direct Deposit Authorization for EFT (Annex D-1). If my form is not on file, I will attach a current Annex D-1,

which includes the W-9 form.

ANNEX E-1 EXTENDED STR ANNUAL OBLIGATION FORM

Form Annex E-1 - Obligation Request Form - 2015-2016 Page 2

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