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Click ‘Get Form’ to open the request tuition form sample in the editor.
Begin by entering the Calendar Year and selecting the Semester for which you are requesting tuition remission. Ensure you include any summer session details if applicable.
Fill in your Employee Name, SSN, and Date of Hire. If you have prior USM service, indicate this as well.
Complete the sections regarding your employment status, including whether you are full-time or part-time, and provide your Institution Work Address and contact information.
Next, enter the Student Name (for spouse/child) and their SSN. Specify their relationship to you and their Date of Birth if applicable.
Indicate the number of credit hours to be remitted and confirm whether an institution transfer of funds is required.
Finally, review all entries for accuracy before signing the Affidavit section to affirm that all information provided is true.
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Accounting Code: HR Signature. Date. Tuition Reimbursement Request Form. **Must turn in to HR proof of enrollment, receipts and grades to receive reimbursement.Read more
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