Fillable Employee Tuition Exemption Request (Green River Community College)

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Employee Tuition Exemption Request (Green River Community College)

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The Employee Tuition Exemption Request (Green River Community College) form is 1 page long and contains:

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  • 10 check-boxes
  • 27 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Green River Community College

BROWSE GREEN RIVER COMMUNITY COLLEGE FORMS

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S
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TUITION
EXEMP
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REQUES
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STUDENT INFORMATION
Name: Date of Birth:
Last First M.I.
SID: Quarter: ❑ Summer ❑ Fall ❑ Winter ❑ Spring Year:
Address:
Street City State Zip
Evening Phone: Daytime Phone:
Position title: How long in this position?
Years Months
Purpose for taking coursework: ❑ To complete a degree ❑ To enhance work skills
❑ For personal enrichment ❑ Requesting class for salary schedule placement
❑ I have read the Guidelines and hereby request a tuition exemption as a classified/permanent employee of the State of Washington.
Student Signature: Date:
PROPOSED SCHEDULE
Item No. Dept. Course No. Course Title Credits
AUTHORIZING PERSON
This section must be filled out and signed by Human Resource Officer or Commanding Officer. See back for eligibility details.
Name:
Title: Phone:
Agency:
Address:
Street City State Zip
❑
I certify that this employee is a full-time/part-time permanent employee of the State of Washington and is eligible to enroll under the tuition exemption program.
Authorizing Person Signature: Date:
ES1509TuitionExemption
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OFFICE
USE
ONL
Y
Date: Processed by:
This document is available in alternative formats to individuals with disabilities by contacting Disability Support Services at 253-833-9111, ext. 2631; TTY 253-288-3359; or by email at dss@greenriver.edu.
Green River College is an equal opportunity educator and employer. Learn more at www.greenriver.edu/accessibility.
greenriver.edu/enrollment • (253) 833-9111 Ext. 2500 • 12401 SE 320th St., Auburn, WA 98092
enrollmentservices@greenriver.edu • fax (253) 288-3454
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S
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EMPL
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REQUES
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greenriver.edu/enrollment o (253) 833-9111 Ext. 2500 o 12401 SE 320th St., Auburn, WA 98092
enrollmentservices@greenriver.edu o fax (253) 288-3454
To be eligible for the tuition exemption program, an employee must be a full-time/part-time permanent employee of a state
agency and be certified as eligible for the exemption according to chapter 88, Laws of 1990, 51st regular session.
ELIGIBILITY
o Classified/Permanent State Employees working 20 hours or more per week and receiving benefits.
o Green River College Permanent Staff working 20 hours per week and receiving benefits.
o Green River College Full and Part-Time Faculty currently employed are eligible. (Part-time is at least
50% for current quarter.)
o Eligibility must be verified by Human Resource Department or Commanding Officer.
o Space available basis only.
REGISTRATION PROCEDURES
1. Complete an application for admission for the first quarter of attendance.
2. Complete the reverse side of this form.
3. Complete the Registration/Change of Schedule form, instructor’s signature is required.
4. Register between the 4th and 10th day of the quarter. All fees are paid by the time of registration.
FEES
o A registration fee will be charged per course, per quarter to cover the costs of the program administration.
Fee is published in the quarterly class schedule.
o Participants will be charged any classroom fees as published in the quarterly class schedule.
Failure to pay fees by the time of registration will result in removal from class without prior notification.
ES1509TuitionExemption
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Green River College does not discriminate on the basis of race, creed, color, national origin, sex, sexual orientation, age, marital status, religion, disability, genetic information or on any other unlawful basis. The college is committed to
preventing and stopping discrimination, including harassment of any kind and any associated retaliatory behavior. The following person has been designated to handle inquiries regarding the non-discrimination policies: Vice President
of Human Resources, 12401 SE 320th Street, Auburn, WA 98092-3622, (253) 288-3320. To receive this information in an alternate format, please contact Disability Support Services at (253) 833-9111, ext. 2631; TTY (253) 288-3359.
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Employee Tuition Exemption Request (Green River Community College)

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Completed 26 July 2020

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