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Course Tuition Reimbursement Form

STEP 1
REVIEW THE TUITION REIMBURSEMENT DIRECTIONS CAREFULLY & COMPLETE THE FIELDS BELOW
IF QUESTIONS, PLEASE CONTACT MYRNA.LAWS@REDCLAY.K12.DE.US

CLICK HERE TO VIEW TUITION REIMBURSEMENT DIRECTIONS

First Name*

Last Name*

Employee ID*

Location*

City:*

State:*

Zip:*

Address 1:*

Address 2:

Email*

Phone*

Subject*

Area of Certification*

Grade

College or University*

Course Number*

Course Title*

Course Start*

Course End*

Credits to be Earned*

Cost Per Credit*

Reason for taking the course

Attach a copy of course description here

STEP 2
RIGHT CLICK AND PRINT THIS FORM AND KEEP IT.
MAKE SURE YOU PRINT IT BEFORE YOU CLICK SUBMIT.
YOU NEED TO INCLUDE THE PAPER COPY IN YOUR PACKET.

STEP 3
SUBMIT FORM FOR APPROVAL.
YOU WILL RECEIVE AN EMAIL WHEN THE FORM IS APPROVED/DENIED.
PRINT THE APPROVAL EMAIL & INCLUDE IT WITH YOUR PACKET

By clicking SUBMIT I certify that I have read the statements on this application & that the information is correct. I certify that this course will provide skills & knowledge for improving my instructional effectiveness. I hereby indemnify & hold harmless RCCSD for any sums determined to be due by the IRS because the course for which reimbursement is made does not meet deductibility requirements.