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Home My WebLink About160014 05/28/2008 E CIT i F CARMEL, INDIANA VENDOR: 00351721 Page 1 of 1 0 ONE CIVIC SQUARE JAMES PAGE CHECK AMOUNT: $3,120.00 CARMEL, INDIANA 46032 CHECK NUMBER: 160014 CHECK DATE: 5/28/2008 DEPARTMENT ACCOUNT PO NUMBE INVOIC NUMBER AMOUNT DESCRIPTION 1202 4128000 3,120.00 TUITION REIMBURSEMENT 06Ltr£bs (Ll£) XV=l S£Z£ Q[£) 8IZ9b NI `SI L9M X08 'O'd 3O` ld 31` (INOAV IL2 *1IaJ:S3IVaS .S1I3Aa `S.N3afI.LS .V1IaAa .IH QIVd Saad AHOJ.VaNVIV A f L •S.LI�iffIVi407 3LVa 3 I.i. aS31I ti 3Ja'I'IOH a.Lva 0 Z '1I301Id 1103 S3S,IN /S:IouvH7 aNV `c Va afla .LNaIALCVd `Saa3 `S LSOU HAOgV :III.L 30 ONIQNV.LSII£fa,\Il HHH /SII I O.L SJ.Sa:LJ V q; .Tu l; Dls SlINa(if1.LS aHJ. 'J.N1IODDV S LMJCli I.LS -HIJ. 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SI N HERE i X 7 582013b r. _,l. Nupw Th a l th card kientW on tpds Item is authorized to pay the ampw(sho— as TOTAL uch TOTAL (tgther fth any other c�� due govemb the use of such m CUSTOMER: RETAIN THIS COPY FOR YOUR RECORDS 40A 366 'Tktfi� wl 0 DATE RECEIPT AMOUNT DESCRIPTION YOUR NEW YOUR OLD NUMBER RECEIVED BALANCE BALANCE RECEIVED OF MARTIN UNIVERSITY 36843 2171 AVONDALE PLACE INDIANAPOLIS, INDIANA 46218 (317) 543-3248 17-11 yit SIGNATURE RECEIPT 4 /30 /0$ 03:21 pm r Martin University Final Grade Report Term: WI -08 "`NIARTIT� UNI VERS5 James E Page 3961 N Broadway Student ID Indianapolis IN 46205 Phone: (317) 924 -9367 College Level Masters Degree Program: URBAN MINISTRY STUDIES Advisor: SITYNE, O'NEAL M QW1 Ib MM UMS 511 50 Biblical Found. for Urban Ministry 3.01 A 1 3.0 12.0 UMS 521 50 Religions of the World 3.01 A 1 3.01 12.0 W N Term: 6.0 6.0 6.0 24.0 4.000 100.0% Cumulative: 9.0 9.0 9.0 36.0 4.000 100.0% 2171 AVONDALE PLACE P.O. BOX 18567 INDIANAPOLIS, IN 46218 (317) 543 -3235 FAX (317) 543 -4790 City Of Carmel Tuition Reimbursement Application Form Part I (to be completed by employee) (Please print. Submit completed form to Department Head prior to commencement of course.) Employee Name Department 1-�rIr g d� l5 (e SSN y Hire Date 3 Z Educational Institution* JM rtAz Name of Course C'L /G' Starting Date of Course (month/day /year) Z2- Z 12 D 0 _F By signing below, I signify that I understand the following: The tuition reimbursement program is subject to the terms of Cannel 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 Cannel 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 law. which may change from time to time. Employee Signature Date Z 2 7 Part II (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 departments budget, subject to the terms of Section 2 -59 of Cannel City Code. Department Head Signature Date �L' 2 Zy Part III (to be completed 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. City Of Carmel t 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 �q L P a Department 12LOY'YYIGI� "Ld2 5Y5�ew!� SSN % Date Z 9 -200 Educational Institution* Name of Course 0, ,,'CC Starting Date of Course (month/day /year) /7 2- Z (ice 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 Cannel 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 law, which may change from time to time. Employee Signature G Date 9 1 S Part I1 (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 bud get, subject to the terms of Section 2 -59 of Carmel City Code. Department Head Signature Date Part III o be completed by Director of Human Resources) J� Final Approval mac` Date y D 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 accrediter. An application will not be considered complete unless a course description fi'om the school's literature is attached. 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 service rendered, by yuhom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee James Page Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total 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 VOUCH F%- NO. James Page ALLOWED 20 IN SUM OF ON ACCOUNT OF APPROPRIATION FOR GENERALFUND 1202 Informatin Systems Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I 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 20 Sig ure Cost distribution ledger classification if Title claim paid motor vehicle highway fund