Application For Tuition Reimbursement And/or Salary Upgrade printable pdf download

LAKOTA LOCAL SCHOOL DISTRICT

APPLICATION FOR TUITION REIMBURSEMENT and/or SALARY UPGRADE

ARTICLE 50 - TUITION REIMBURSEMENT

A. The Board shall set aside a fund of Fifteen Thousand Dollars ($15,000.00) each school year for tuition reimbursement, and shall reimburse each

employee by October 31 up to fifty percent (50%) of the cost of tuition and fees for graduate coursework completed and earned each preceding

fiscal year (July 1 – June 30). Payment for tuition in private institutions will be no more than fifty percent (50%) of the cost for the same work if

completed in a State college or university.*

*Average of the tuition of Bowling Green State University and Toledo University.

B. Payment will be made upon evidence that the coursework has been satisfactorily completed. A copy of the receipts and an official transcript needs

to be received by the Treasurer by September 30. A maximum of nine (9) semester hours (or equivalent quarter hours) may be reimbursed during

a school year. In the event applications for reimbursements exceed the fund, distributions shall be made on a pro rata basis.

C. Fund balances shall not be carried over into subsequent years. Employees must apply by September 30 to be eligible for reimbursement

under this Article. Employees will only be reimbursed if they are currently employed by the Board.

ARTICLE 40 - COLLEGE CREDIT RECOGNITION

Verification of college training and proper certification/licensure must be filed with the Treasurer of the Board by September 30 for movement

on the salary schedule for the first semester and by January 31 for the second semester. An official transcript of the above coursework must be filed

with the Treasurer by October 31 and February 28 for the first and second semesters respectively. All credit must be from an institution whose courses are

accepted by the Division of Certification, Ohio Department of Education for the purposes of recertification or any other course pre-approved by the

Superintendent.

Name: _________________________________________

Applying for: [ ] Tuition Reimbursement

[ ] Salary Upgrade

[ ] Both

College/University/Organization: ___________________________________________________________

Today’s Date: ________________

1. Course and Program: _______________________________Your Cost $__________Dates:____________ Hours: ______ [ ] Qtr

[ ] Sem

2. Course and Program: _______________________________Your Cost $__________Dates:____________ Hours: ______ [ ] Qtr

[ ] Sem

3. Course and Program: _______________________________Your Cost $__________Dates:____________ Hours: ______ [ ] Qtr

[ ] Sem

___________________________________________________For Treasurer’s Office Use__________________________________________________

Today’s Date: ________________

Attached: [ ] Original Transcript

[ ] Evidence of Payment

SALARY UPGRADE:

TUITION REIMBURSEMENT:

Current Status: __________________

1. Cost $_______________

Reimbursement $_______________

Awarded:

__________________

2. Cost $_______________

Reimbursement $_______________

Upgraded to:

__________________

3. Cost $_______________

Reimbursement $_______________

9/2/2010

TOTAL REIMBURSEMENT $____________

Application For Tuition Reimbursement And/or Salary Upgrade

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