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HomeMy WebLinkAbout306945 01/12/17 CITY OF CARMEL, INDIANA VENDOR: 00353332 CHECK AMOUNT: S""""600.60" t! MICAH BECK CHECK NUMBER: 306945 ONE CIVIC QUARE C/0 CARMEL UTILITIES .1 CARMEL, INDIANA 46032 C/0 CARMEL UTILITIES CHECK DATE: O /12117 DESCRIPTION DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUN600T 60 OTHER EXPENSES 651 5023990 E N E ca O m n LL 0 W U CO Z O i Aw O Q v Q cr °' a w OGo co *+ a U r O W M Q Q o f rn t O d > 4k as Z0 -0 W N U O z > 3 M ` U g U) Y V z c o C m U _ O a City Of Carmel Tuition Reimbursement Application Form __---- --------- Pa I I (to be completed by Employee) (Please print. Submit col npleted form to Department Headrip or to date course begins.) Employee ame `'/ C h SSN�09�©�1 Hire Date q-1©- �0o l Department Job Title Educationa c Institution* ti C Name of Course"* 1 z i 8 m e k a 5 8 f �J e T A�^ Credit Hours Starting Date of Course(month/day/ ear) By signing below, I signify that I understand the following: • The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2-58. • To receive reimbursement for'Ituition, I must submit evidence of payment for the course and a copy of my final grade. To receiv$reimbursement for books, I must submit an original itemized receipt or other proof of purchase that links these books to this particular course. • If I leave City of Carmel em loyment sooner than one (1) year after the end of this course, I will repay the City in full for itst tion and book reimbursements for this course. • The t status of reimburs 't ayments is subject to federal law,which may change from time to time. / n - Employee Signature G Date f °C 41� Part IIto be completed by Department Head)i By signing below, I certify that: • I have read the course description attached to this application and believe this course will maintain or improve the employee's job-related skills, in relation to either the employee's current position or potential careei path within my departm t. • The pplicant will have been employed full-time by the City for at least one (1) year prior to the com encement of the course, nd has not been subject to a disciplinary probation, suspension or demotion withii 190 days prior to the begi' ning of the course. • The nal claim will be paid fr m my department's budget, subject to the terms of Section 2-58 of Carmel City Code. Department Head Signature ature Date Part III (to a completed by Director of Human Resources) Final Approval Date If denied reason for denial * The tuition reimbursement progra n covers only courses offered through a degree-granting institution accredited by the North Central Association of Col ges and Schools or an equivalent regional accreditor. ** consid red complete unless a course description from the school's literature is attached. Ana plication will not be City Of Carmel Tuition Reimbursement Application Form Par I,I (to be completed by Employee) (Please print. Submit co pleted form to Department Headrip or to date course begins.) Employee Name -'Ille1 0 � C� 'I C� � SSN3Jy. gX-pqQS Hire Date `/ O vo Department 4• 1,A t PS Job Title Educational Institution* ] Der- h Name of Course"* S � � �-)t C C' S S Credit Hours Starting Date of Course(month/day/ ear) - 2 '2 By signing below, I signify that I ilinderstand the following: • The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2-58. • To receive reimbursement for tuition, I must submit evidence of payment for the course and a copy of my final grade. To receive reimbursement for books, I must submit an original itemized receipt or other proof of purchase thal links these books to this particular course. • If I leave City of Carmel em loyment sooner than one (1) year after the end of this course, I will repay the City in full for its W tion and book reimbursements for this course. • The taK status of reimbu mente ayme " is subject t eder ,law,which may change from time to time. Employee Signature ,2L , :' Date 0�7 _______=____--------------- Part II to be completed by Department Head) By signing below, I certify that: • I have read the course descrip ion attached to this application and believe this course will maintain or improve the employee's job-rel ted skills, in relation to either the employee's current position or potential career path within my departme t. • The applicant will have been) employed full-time by the City for at least one (1) year prior to the commencement of the course, d has not been subject to a disciplinary probation, suspension or demotion within 90 days prior to the begi ning of the course. • The f nal claim will be paid from my department's budget, subject to the terms of Section 2-58 of Carmel City Code. Department Head Signature Date -- Part III (to b completed by Director of Human Resources) Final Approval Date If denied reason for denial * The t iition reimbursement prograi n covers only courses offered through a degree-granting institution accredited by the Nordi Central Association of Colleges and Schools or an equivalent regional accreditor. ** An al plication will not be conside ed complete unless a course description from the school's literature is attached. Printable Bil I Page 1 of 2 Statement Term Due Date Amount Due Date 08/09/2016 Fall 2016 08/19/2016 $600.60 (201620) 0 West Fall Creek Pkwy Nl Dr Indianapolis, IN 46208'' Micah W. Beck 317.921.4800 �I 1817 Woodstream Ct http://www.ivytech.edt Westfield, IN 46074-9396 Student ID: C05730057 Fall 2016(201620) Schedule CRN UBJ CRSEtDHH SEC COURSE TITLE CREDS DAYS START/STOP BUILD ROOM 30050 OMM 101 F ndamentals Pu 3.00 M 0600-0950pm NOBLE 133 25204 IVYT 111DJH S{ dent Success 1.00 F 0600-0750pm NOBLE 131 Total Credit Hours:4.00 Account Summary Charges Credits/Anticipated Credits 1-11-Technology Fee 60.00 H4-In State Tuition 540.60 Total Char es: $600.60 Total Credits/Anticipated Credits: $0.00 Previ us Balance I Current Term Balance Amount Due FutureBalance 0.00 $600.60 $600.60 $0.00 I I i i https:Hsect re.touchnet.net/C2000 tsa/tapp?tapp-stoken=yqugoCcxEKo&Navigate=print_s... 1/6/2017 4 n m 2 V -"Jn D Ncfl A 7 NOy= Gf 3c o cr m CL c Co m � 3 w w �z c I v I 1 s II i x v r I , I ,y �I i ' I '. II j ' to i t V m b : a i i m S pr C ��- � � m w C msat CL o o _ cu CL ' n 0-0 c CL co n I � O c � m o� o� . At 0 r _r4010 ja $ � o o � Q cCD CD i