Classwork Advance &
Reimbursement Request
TP-26
Name
*
Email
*
Actual Time in School:
From
-
Month
-
Day
Year
at
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Date Picker Icon
To
-
Month
-
Day
Year
at
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Date Picker Icon
Total
Days
Weeks
Total Days/Weeks?
Workshop/Classes Attended:
Hours/Credit Received:
QTR
SEM
Amount of Advances Received:
Expenses:
Tuition
Fees (List types if more than one)
1. Amount and type
2. Amount and type
3. Amount and type
Total Fees
Housing (Dormitory)
Mileage (one round trip)
Number of miles
Number of miles X $0.38 per mile =
Tolls
Submit this form and mail all your receipted invoices and an official
transcript for this work within 30 days of the close of the class(es)
or
no later than October 15. Otherwise, any advances will be
deducted from the November paycheck.
Submit
Should be Empty: