<p> FIELD HOURLY TUITION REIMBURSEMENT ASSISTANCE APPLICATION Must work and maintain 25 hours per week to participate in the Tuition Assistance Reimbursement Program. Must be employed by the company six months prior to course completion, one year of service required for Graduate studies. Submit signed application, itemized receipt of tuition expenses and corresponding grades, within 60 days of the course completion date, to Team Member Services via fax number 972.307.6069 You are responsible for the initial payment of tuition and ensure all documents are received by Team Member Services within 60 days of course completion.</p><p>Name Employee ID: Telephone/Email: Location: Course Dates: Name of School: Beginning ______Degree: Ending ______Program: □ Graduate □ Undergraduate □ High School □ Vocational □ Other</p><p>Course# Course Name Course# Course Name</p><p>Student Signature Date: For Team Member Services Use Only – Do Not Write Below Date of Hire: Final Course # Grade Tuition Cost Year of Participation______Reimbursement Amount 1. Previous Reimbursement 2. Previous Reimbursement 3. Previous Reimbursement 4. Current Reimbursement 5. Pay Period End Date 6. Reimbursement Approved by</p><p>Approved □ Denied □ Average hours/week______Reason for Denial______</p><p>4/6/2018</p>
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