160390 06/10/2008 CITY OF CARMEL, INDIANA VENDOR: 132750 Page 1 of 1
ONE CIVIC SQUARE AARON HOOVER
CARMEL, INDIANA 46032 1301STAVE SW CHECK AMOUNT: $805.00
CARMEL IN 46032 CHECK NUMBER: 160390
CHECK DATE: 6/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 060908 805.00 OTHER EXPENSES
I
City Of Carmel
Tuition Reimbursement Application Form
Part I (to be completed by employee)
(Please print. Submit completed for to Department Head rtp �or to commencement of course.)
Employee Name c v Cv
C C 2 I) D epartrnent C'i c f +t'�ti� SSN � Hire Date
Educational Institution* n d
Name of Course 100 1j1A MQ'n Ie, li I C A) 7_4 o�
Starting Date of Course (month/day/year) g Ll 161 0 E
By sighing below, I signify that I understand the following:
The tuition reimbursement program is subject to the terms of Carmel City Code, Section 2 -59.
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 the book list for the course
and an original itemized receipt for all books purchased.
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 reimbursem t paymen is subject to federal law, which may change from time to time.
Employee Signature Date
Part lI (to be completed by Department Head)
(Submit to Human Resources)
By signing below, I 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 Sec n 2 -59 of Carmel City Code. l
Department Head Signature Date 3/0
Part III (to be completed by Director of Human Resources)
Final Approval a.�-�t �c�,r- Date t-i O Z O
If denied, reason for denial
The tuition reimbursement program covers only full- semester courses offered through a degree granting institution
accredited by the North Central Association of Colleges and Schools or an equivalent regional accreditor.
An application will not be considered complete unless a course description from the school's literature is attached.
Course Course
No. Course Title Length Credits Books Fees* Tuition Total
Initial Deposit *$100.00
UNV111 Philosophy Practice of Lifelong Leaming I 4 weeks 2 $102.00 $470.00
ENG140 Communications I 5 weeks 3 $140.00 $100.00 1 $705.00 $1,617.00
ENG141 Communications U 5 weeks 3 $0.00 $105.00 $705.00 $810.00
CIT112 Intro. to Computer Information Technology 5 weeks 3 $90.00 $705.00 $795.00
PHE140 Concepts of Wellness 4 weeks 2 $64.00 $470.00 $534.00
BIL102 New Testament Survey 5 weeks 3 $49.00 $705.00 1 .$754.00
COM115 Introduction to Human Communications 5 weeks 3 $91.00 $705.00 $796.00
CIT220 Desktop applications 6 weeks 4 $104.00 $940.00 $1,044.00
I1�S 80 -Humanities World Civilizatio :T X1.00.00_ 705.00_ $805100
MAT108 Modem Concepts of Mathematics 5 weeks 3 $85.00 $705.00 $790.00
PSY155 Psychology of Personal Adjustment 5 weeks 3 $109.00 $705.00 $814.00
ENG242 Literature and Ideas 5 weeks 3 $98.00 $705.00 $803.00
CIT140 Operating Systems Concepts 5 weeks 3 $119.00 $705.00 $824.00
CIT120 Introduction to Programming Concepts 5 weeks 3 $47.00 $705.00 $752.00
MUS180 Humanities: Fine Arts 5 weeks 3 $140.00 $705.00 $845.00
PHL283 Philosophy and Christian Thought 5 weeks 3 $97.00 $705.00 $802.00
CIT262 Network Communications 5 weeks 3 $126.00 $705.00 $831.00
CIT260 Database Concepts 5 weeks 3 $99.00 $705.00 $804.00
CIT270 E- Commerce and Web Development 5 weeks 3 $112.00 $705.00 $817.00
CIT272 Hardware and Software Troubleshooting 5 weeks 3 $137.00 $75.00 $705.00 $917.00
CIT280 Project Management and Integration Capstone 5 weeks 3 $105.00 1 $705.00 $810.00
TOTAL 62 $2,114.00 $280.00 1 $14,570.00 j $16,964.00
'union: $235.00 per credit hour *Educational Resource Fee: $205.00, Graduation Fee: $75.00
?AYMENT PROCESS
k. Deposit"
W initial deposit of $100.00 must be submitted to the Marion office. Payment may be mailed in or phoned in using VISA,
4asterCard, or Discover (if the class is full when your deposit is received, your name will be placed on a waiting list). Regardless
if how subsequent payments will be made (financial aid, veterans' benefits, etc.), the $100.00 deposit is still required.
3. Balance of First Payment
'he remaining balance of your first payment for the first two courses must be received in the Marion office by noon 14
ays prior to the class start, or your name will be dropped from the class list and you will be ineligible to start this session.
ate payments will not be accepted.
Direct Payment to.'
Indiana Wesleyan University LEAP Office 1900 W. 50th Street e Marion, IN 46953
800 -234 -5327, option 2 i 765- 677 -3265
Indiana Wesleyan University reserves the right to change information in this document without notice.
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,
F
price per unit, etc.
Payee
132750
AARON HOOVER Purchase Order No.
SEWER COLLECTION Terms
CARMEL, IN 46032 Due Date 6/4/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/4/2008 060908 $805.00
hereby certify that the attached invoice(s), or bill(s) is (are) true and
-orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 085639 WARRANT ALLOWED
132750 IN SUM OF
AARON HOOVER
SEWER COLLECTION
CARMEL, IN 46032
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
060908 01- 7040 -01 $805.00
Voucher Total $805.00
Cost distribution ledger classification if
claim paid under vehicle highway fund