Faculty Staff Tuition Benefit Form
Employee Information
Employee Name:
First Name
Last Name
Employee Title:
Employee Email:
example@example.com
Name of Student Applying for Benefit:
First Name
Last Name
Expected High School Graduation Date:
-
Month
-
Day
Year
Date
Employee Hire Date:
-
Month
-
Day
Year
Date
Relationship to Employee:
Benefit Applying For:
Knox Tuition
ACM Tuition
Tuition Exchange
$500 Reimbursement at a college other than Knox, ACM, or TE
Submit
For Human Resources Only
Approved by Human Resources
Yes
No
Year Benefit Applies to:
Comments
Date
-
Month
-
Day
Year
Date
Should be Empty: