157116 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: 360928 Page 1 of 1
ONE CIVIC SQUARE INDIANA WESLEYAN UNIVERSITY
CARMEL, INDIANA 46032 LEAP OFFICE CHECK AMOUNT: $1,119.00
1900 W 50TH STREET
CHECK NUMBER: 157116
MARION IN 46953
CHECK DATE: 3/5/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4128000 1,119.00 TUITION REIMBURSEMENT
Prebill Invoice
13- DEC -2007
JOHN M JOKANTAS
14703 Strauss Dr #1924
Carmel, IN 45032
Customer Number: 339252
Group Number: BSCJOL 06
Start
Course /Fee Date Due Date Amount
CRJ /281 Principles of Criminal Justice 04- DEC -07 04- DEC -07 825.00
Books CRJ /281 04- DEC -07 04- DEC -07 294.00
Educational Resource Fee 04- DEC -07 04- DEC -07 94--94
Balance Due Institution
PLEASE REMIT PAYMENT BY THE DUE DATE. E j J 19. o
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City Of Carmel
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.)
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Employee Name l'1 K�[� n L
Department C--OM. M u h o SSN Hire Date O F /LC�)
Educational Institution* 64 nc4
Name of Course V(' I CI
Starting Date of Course (month/day /year) d_O 0
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 -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 reimbu ement paym is is subject to federal law, which may change from time to time..
Employee Signature i Date 1 oz/0 3 o
feted b D Head
Part II (to be comp y p
(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 2 -59 of Carmel City Code.
Department Head Signature 6' ��r Date be 2 -07
Part III (to be complet by Director of Human Resources)
Final Approval Date
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.
Awl
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WESLEYAN CRJ -281 -A Principles of Criminal Justice 3.00 A
U N I V E R S I T Y
RECORDS OFFICE
4201 South Washington Street
Marion, Indiana 46953
John M. Jokantas
1660766
12/04/07 02/11/08 F:
SUMMARY HOURS TOTAL NON QUALITY QUALITY QUALITY GRADE
J` ENROLLED EARNED HOURS HOURS POINTS POINTAVG
......._CURRENT....
CUMULATIVE
3.00 66._00 1 0.00 3.00 12.00 4.00
Indiana Wesleyan Unive rsity Cumulative GPA reflects hours earned at Indiana Wesleyan University only. Calculation for Baccalaureate honors may include
transfer hours. Current status of Baccalaureate honors:
is aChrist- centered
academic community GRADED HOURS 66.00 (min. 80 req.; 40 In us. IWU) HONORS GPA 3.27 N
committed to 3
ALL ERRORS MUST BE REPORTED WITHIN TWO WEEKS.
changing the world
EXPLANATION OF GRADES, POINTS, AND CREDIT HOURS THE UNIT OF CREDIT ISTHE 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.
8 10 Good NR No grade report given
and leadership. B- 2.7 CR Credit Equivalent toCorabove
C+ 2.3 NC Non 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 Unsatisfactoy
http:fi www. indwes .edu /recordsltranscripts.htm. IP In Progress
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VOUCHER NO- WARRANT NO.
ALLOWED 20
Indiana Wesleyan University
IN SUM OF
Leap Office
1900 W. 50th Street
Marion, IN 46953
$1,119.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept.# INVOICE NO. ACCT #/TITLE AMOUNT Board Members
CRJ281 41- 280.00 $1,119.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Wednesday, February 27, 2008
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
r
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/13/07 I CRJ281 I I $1,119.00
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
20
Clerk- Treasurer