GEORGIA ASSOCIATION OF REALTORS® Scholarship Foundation
SCHOLARSHIP REIMBURSEMENT REQUEST FORM
SECTION I – SCHOLARSHIP RECIPIENT INFORMATION
Recipient Name:
*
Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number:
Format: (000) 000-0000.
License Number:
Email Address:
*
example@example.com
Award Year:
SECTION II – REIMBURSEMENT TO SCHOLARSHIP RECIPIENT
This form is used only to request reimbursement to a scholarship recipient for eligible educational expenses that have been paid by the recipient, in accordance with the Foundation's Policies and Procedures Manual.
Reimbursement Type
Individual Course Reimbursement
Bundled Course Reimbursement (Multiple Courses)
(Bundled reimbursement requests are permitted under Section 6.4 of the Policies and Procedures Manual and may include multiple related courses submitted in a single request.)
SECTION III – EDUCATIONAL INSTITUTION INFORMATION
Primary Educational Institution / Course Provider:
*
Please Select
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National Association of REALTORS® (NAR)
Georgia Association of REALTORS® (GAR)
Residential Real Estate Council (RRC) – Certified Residential Specialists (CRS)
Certified Commercial Investment Member (CCIM) Institute
Institute of Real Estate Management (IREM)
Graduate REALTOR® Institute (GRI)
REALTORS® Land Institute (RLI)
Georgia Instructor Training (GIT)
Real Estate Educators Association (REEA)
Institution Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Academic Term(s) or Course Period(s):
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If this reimbursement request includes courses completed at more than one educational institution or course provider, please list each additional institution and associated course information on a separate sheet and attach it to this form.
SECTION IV - COURSE COMPLETION AND TIMING REQUIREMENTS
For each course included in this request, please provide the following information:
Course Name / Description Completion Date
*
Reimbursement Deadline Certification
I certify that this reimbursement request is submitted within sixty (60) days of completion of the course, as required by the Policies and Procedures Manual.
If this request includes
bundled courses
, I certify that this reimbursement request is submitted within sixty (60) days of the completion date of the final course included in the bundle, as required by Section 6.4.
SECTION V - EXPENSE INFORMATION
Please itemize the eligible educational expenses for which reimbursement is requested.
Rows
Amount
Tuition / Course Fees
Required Materials
Other (Explain)
(Only eligible educational expenses approved under the Policies and Procedures Manual may be reimbursed.)
SECTION VI - REIMBURSEMENT CERTIFICATION
I certify that I personally paid the expenses listed above and that I have not been reimbursed for these expenses from any other source.
Date(s) Expense(s) Were Paid:
Method of Payment Used:
Check
Credit/Debit Card
Other
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Reimbursement Payable To:
SECTION VII – REQUIRED DOCUMENTATION
Please attach all applicable documentation:
Proof of course completion for each course listed
Itemized invoice(s) or receipt(s) identifying each course
Proof of payment (receipt, canceled check, or transaction record)
Additional documentation requested by the Foundation
Supporting Scholarship documentation
*
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SECTION VIII. APPLICATION SUBMISSION REQUIREMENTS
All completed Professional Education Scholarship Reimbursement Request Forms, and all required supporting documentation must be submitted electronically to:
Scholarships@GARealtor.com
Applications or reimbursement requests submitted to any other email address, individual, or delivery method may not be received or considered.
The applicant is responsible for ensuring that the reimbursement request and all required materials are successfully transmitted and received by the Foundation within the applicable submission timeframe set forth in the Policies and Procedures Manual.
SECTION IX – CERTIFICATION AND ACKNOWLEDGMENT
I certify that the information provided in this request is true and complete to the best of my knowledge. I understand that submission of this request does not guarantee reimbursement and that all requests are subject to review and approval in accordance with the Georgia Association of REALTORS® Scholarship Foundation, Inc. Policies and Procedures Manual.
I acknowledge that scholarship funds may only be used for eligible educational expenses and that failure to comply with policy requirements, including submission deadlines, may result in denial of this request.
Recipient Signature:
Date:
-
Month
-
Day
Year
Date
Admin Section
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SECTION X – FOUNDATION USE ONLY
Request Received:
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Submission Timely (60-Day Rule Verified):
Yes
No
Eligibility Verified:
Yes
No
Expense Eligibility Verified:
Yes
No
Reviewed by Staff:
Yes
No
Recommended Amount:
Executive Vice President Review:
Yes
No
Date:
-
Month
-
Day
Year
Date
Board of Directors Approval:
Yes
No
Board Approval Date:
-
Month
-
Day
Year
Date
Final Approved Amount:
Payment Issued Date:
-
Month
-
Day
Year
Date
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Should be Empty: