Tuition Reimbursement Application for NC Educator Pipeline Collaborative

Tuition Reimbursement Application for NC Educator Pipeline Collaborative
Full Name:*

First NameLast Name
Phone:*

Area CodePhone Number
E-mail:*
School:*
Work Location
Position:*
Current Position
Area(s) of Teacher Certification in Which You Are Studying:*
Area of Teacher Certification
Date of Initial Employment with Caldwell County Schools:*
Major of Study in Teaching Program:*
Program of Study
License You Wish to Obtain:*
License
The amount to be awarded for tuition reimbursement will be $75.00 per semester hour with a maximum payment for six (6) semester hours per semester, a total of 18 per year. If the cost for tuition is less than $75.00 per semester hour, the actual cost will be paid. Reimbursement shall be used as a supplement to any and all financial aid and with both combined shall not exceed the cost of the courses.
Must provide documentation of admission into the education program has been approved

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Attach Receipt Showing Amount Paid*

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Reimbursement will be made only after documentation that the course(s) is/are completed with some level of an A or B grade *

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Reimbursement for tuition will be made in a timely manner following receipt of grades, and proof of payment for classes. Cancelof

Courses in which you have enrolled:*

	Course Number	Title of Course	Credit Hours	Cost Per Semester Hour
Course Information:
Course Information:

Semester:*
Total Amount Requested for Reimbursement:*
Signature*

Clear
Date*

MonthDayYear
It is the expectation that any candidate who receives tuition reimbursement will work as a teacher for at least two (2) years with Caldwell County Schools upon completion of a degree program if a position is available and offered. It is the expectation that funds provided through this reimbursement process will be refunded to Caldwell County Schools if the two (2) year employment is offered and not fulfilled by the candidate.
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