I certify that I am an employee of the Atlanta Fire Rescue Department and that information entered on this form is true and accurate. I certify that I am not receiving reimbursement funds from another source for the semester/term requested in this application. I am requesting reimbursement for my personal funds expended for college tuition from the Atlanta Fire Rescue Foundation. I acknowledge that it is my responsibility to submit complete, accurate, and timely documentation as requested by the committee.
I do hereby acknowledge and agree to maintain employment with the City of Atlanta for a period of no less than 24 months following the reimbursement of any tuition fees by the Atlanta Fire Rescue Foundation. If I resign, retire or separate from the employment of the Atlanta Fire Rescue Department within 24 months of reimbursement, I must reimburse the Atlanta Fire Rescue Foundation the full amount of the reimbursement within in 90 days of my separation date. I understand that any unpaid balance after 90 days will be turned over to a collection agency.