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Home My WebLink About192159 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 364896 Page 1 of 1 ONE CIVIC SQUARE BLAINE MALLABER 0 CHECK AMOUNT: $464.00 CARMEL, INDIANA 46032 19571 LANDRUM CIRCLE NOBLESVILLE IN 46062 CHECK NUMBER: 192159 CHECK DATE: 11/2312010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023.990 464.00 EMPLOYEE PENSIONS B City Of Cannel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Head rip or to commencement of course.) Employee Name t� /✓I u f 1 a6C.a/ Department (1 I },i? 5 SSN Hire Date 8 131 e 09 Educational Institution* T U h �i �P Y�..�? Name of Course** l 11�r� �t �t 1 I-( f e J` f` do; y e3 ICredi.t Hours J______ Starting Date of Course (month /day /year) 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 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 that links these books to this particular course. If I leave City of Carmel employment sooner than one (1) year after the end of this course, I will repay the City in full for its tuition and book reimbursements for this course, The tax status of reimbursement payments is subject to federal Jaw, which may change from time to time. 1✓`mployee Signature 1 �uvt' ��i�` Date Part II (to be completed by Department Head) (Submit to Human Resources) By signing below, 1 certify that the applicant will have been employed full -time by the City for at least one (1) year prior to the commencement of the course, and has not been subject to a disciplinary probation, suspension or demotion within 90 days prior to the beginning of the course. The final claim will be paid from my department's budget, subject to the terms of Secti n 2 -58 of Carmel City Code. Department Head Signature Date f Part III (to be completed by Director of Human Resources) Date Final Approval e if denied, reason for denial The tuition reimbursement program covers only full- semester courses offered through a degree granting institution accredited by the Nortli Central Association of Colleges and Schools or an equivalent regional aecreditor. An application will not be considered complete unless a course description from the school's literature is attached. Prebill Invoice 30 Aug 2010 Group Number: ASCJO 33 Start Course /Fee Date Due Date Amount UNV /111 Phil /Practice Lifelong Lrng I 25- Aug -10 25- Aug -10 245.00 Books -UNV /.111: 25- Aug -10 25- Aug--m10 219.._00. Educational Resource Fee 25- Aug -10 25- Aug -10 100.00 ENG /140 Communications I 22- Sep -10 25- Aug -10 735.00 Books ENG /140 22- Sep -10 25- Aug -10 177.00 Balance Due Institution 1,476.00 PLEASE REMIT PAYMENT BY THE DUE DATE O R- A PO Please tear off,and mad this sectloii with your payment T' h i you dame i'd'iike:t&make my payment by credit card. GfOUp Visa or Mastercard Discover Amount Enclosed: e V date Check here if reques ng an itemized receipt.: phone nurnber( required) s .(-qu)' >Remit: payment•to :kdiana- Wesleyan- University -Leap- Office 1900 W. 50th.Street Marion IN:46953. k Bank of America I Online Banking I Accounts I Account Details I Account Activity Page 1 of 1 Sign Oft Locations Mail Help En Espanol Accounts Bill Pay Transfers Investments Customer Service Enter keyword(s) Accounts Overview Aocount Details Alerts Open an Account Bank of America Platinum Plus Account Bank of America Platinum Plus V- 5959 ri Account Activity My Statements Services Rewards L 3M fe r p s m l now a g tr�nsfer nhance your acco u u nt nt rie p E expence even fuller with the ShopSate® feature. a an I her Interest rate accd nts to Use ShopSafe I Leant more about ShopSafe save. Roll over for more details Total Points. 5,003 WoddPointsO View my Rewards u Balance Summary 1 111 0128 1 0 Go to: Current Statement J n View: All Transactions r Posted+ rran —tion Type Amount Balance (founded)?i Request a credit line Pending INDIANA WESLEYAN UNIV '3464.08 $ increase ►11A)Wo10 MBLU MEDIACOM 800983 e'n $3487 $ 11/182010 Payment. due data $ Payment Summary :=ay your credit card bills in semads online. Le, :'r more I QSecum Area Accounts Bill Pay Transfer Funds Investments Customer Service Privacy 8 Security Locations Alerts Mail Help Site Map Sign 08 Bank of America, N.A. Member FDIC. Equal Housing Lender Q 02010 Bank of America Corporation. All rights reserved https:// ccss- rva.bankofamerica.com/cess /S SOEntry?pageid= 102 &target= aectOverview &a... 11/10/2010 i INDIANA WESLEYAN UNIVERSITY RECORDS OFFICE r fi 4201 South Washington Street I, Marion, Indiana 46953 Blaine P. Mallaber 08 /10 09 /21/10 F I g yy i r V P G 1 SUMMARY HOURS TOTAL NON QUALITY QUALITY QUALIFY GRADE ENROLLED EARNED HOURS HOURS POINTS POINTAVG. CURRENT CUMULATIVE M000 1 •00 <t 4 00 g :00. Indiana Wesleyan University Cumulative GPA reflects hours earned at Indiana Wesleyan University only. Calculation for Baccalaureate honors may include is a Christ centered transfer hours. Current status of Baccalaureate honors: academic c o mmunity GRADED HOURS (min. 80 req.; 40 hrs. IWU) HONORS GPA committed to ALL ERRORS MUST BE REPORTED WITHIN TWO WEEKS. changing the world EXPLANATION OF GRADES, POINTS, AND CREDIT HOURS THE UNIT OF CREDIT ISTFIE SEMESTER HOUR. by developing students A 4.0 Excellent WF Withdrawal while failing Grade point average based on quality points A- 3.7 W Withdrawal while passing divided by quality hours. Total earned hours in character, scholarship B+ 3.3 1 Incomplete count toward graduation requirements. B 3.0 Good NR No grade report given and leadership B- 2.7 CR Credit Equivalent toCorabove C+ 2.3 NC Nan Credit Equivalent to below C C 2.0 Average AU Audit C- 1.7 NA Failure to Audit TRANSCRIPT INFORMATION D+ 1.3 0 Outstanding To request an official transcript, information is D 1.0 Passing S Satisfactory available by phone at 765- 677 -2966 or online at F 0.0 Failure U Unsatisfactory http:// www. indwes .eduirecords/transcripts.htm- IP In Progress r VOUCHER 106574 WARRANT ALLOWED T1998 IN SUM OF MALLABER, BLAINE CARMEL WASTEWATER Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 112210 01- 7042 -06 $464.00 Voucher Total $464.00 Cost distribution ledger classification if claim paid under vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show, kind of service, where performed, dates of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee T1998 MALLABER, BLAINE Purchase Order No, CARMEL WASTEWATER Terms Due Date 11/15/2010 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 11/15/201( 112210 $464.00 I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 Date Officer