161931 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00352754 Page 1 of 1
ONE CIVIC SQUARE TED LENZE
CARMEL, INDIA14A 46032 5575 BUTTONWOOD DRIVE CHECK AMOUNT: $399.29
NOBLESVILLE IN 46060 CHECK NUMBER: 161931
CHECK DATE: 7/23/2008
DEP ACCOUNT PO NUMBER INVOIC NU MBER AMOUNT DESCRIPTION
1120 4128000 399.29 TUITION REIMBURSEMENT
011002008 16:21 3175714244 CARMEL FIRE DEPARTMT PAGE 01
Jan 04 2008 12 :54PM Carmel Fire Department St 8183404 p•'1
City, Of C armel
Tuition Reimbursement .Application Farm
Park I (to be completed by employee)
(Please Prune. Submit completed form to Deputtrnent Had Rd r to cammeneen=t of course.)
Employee Name rAL 'D t7O f1
Department F/TL SSN HiraDate a/,C'fff
EducatiomelInstitution* T I/!4 ra
Name of Course f+ ATb MV prri%o toe y le
Starting Date of Course (mentb/day/yesr)
By signing below, I signify that I understand the following;
e The tuition reimbursement program is subject to the terms of Carmel City Coda, Section 2 -59.
Y To rcceive 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.
o If I live City of Carmel employment sooner than. me (1) year after this. end of this course, l will
prepay the City in full for its tuition and book reimbursements for this course.
e The tax status of reimbu ent s subject federal law, which may cue $rnm time to time.
�P Sisnaturc I Date yf D
mrz+a
Part II (to be completed by Department Mead)
(Submit to Human Resouroes)
By signing below, l certify that the applioarlt will have, begs employed full -time by the City for at least one (1)
year, prior to the commc=ment 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. a final claim will be paid from my
department's budget, subject to the terms of Section 219 of 1 Code.
A
Departmealt Head 9ignatur+e c �—✓r� L C S Dane o
Part M (to be completed by IDi for oiiuman Resources)
Final Approval
G-►,� Date o
If denied, reason for denial
o The twit rein bu sement program covers only fidlsinnesw coumes offined through a degxee VuWng institution
acaodit�ed by the Haab Central AseOoiadion of Collosm and Sohools or as oquuvalcnt rceanal eccrediion
An appOcation will not be comsidered complete union a amw desra"ou *om rho schoOro litemturo is Matched.
h0
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Lenze, Theodore A
2008 SPRING
To choose another Term, choose Select Term from either the Term navigation bar or in the SITE MAP.
Due Date:
Previous Balance: 0.00
Amount Due Through Selected Term: 0.00
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Current Term 2008 SPRING
Effective Date Subcode Description Charges Credits
01 -11 -08 11001 Al TUITION IN -STATE 273.90 0
01 -11 -08 21034 INTERNET -BASED DE FEE -A1 30.00 0
12 -14 -07 27000 H1 Technology Fee 40.00 0
01 -14 -08 27122 PRIOR LEARNING ASSESSMENT -H1 135.00 0
01 -12 -08 60001 STUDENT REFUND AUTOMATIC 303.90 0
01 -25 -08 97005 CHECK PAYMENT 0 303.90
12 -14 -07 97010 VISA /MC PAYMENT 0 647.80
01 -14 -08 97010 VISA/MC PAYMENT 0 135.00
01 -25 -08 97010 VISA /MC PAYMENT 303.90 0
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Any problems or comments call the SOS Helpdesk at 1- 877 -IVY -TECH or report_the._problem_online.
Admissions Office I Bursars Office I Registrar's Office_ I Financial Aid_Office i Dsability_Support_Services. I Career Services.
RELEASE: 1.20
https:Hweb4.ivytech.edu/ia- bin/tsrvweb 6/30/2008
im-mmey. =P
PO BOX 2349 #KA16F5 New Balance
KALAMAZOO MI 49003 -2349
Total Amount Due
Due Date 02/15/08
Account Number
Total Enclosed
Address or Email change? Print new address on back of statement.
I By mail, your payment may take 5 -7 days to reach us.
PLEASE MAKE CHECK PAYABLE Q t JENNIFER M LENZE 22043
��F 3 THEODORE LENZE JR
NATIONAL CITY ti_,. i 5801 CORRALBERRY CT
P.O. BOX 856176 CARMEL IN 46033 -9598
LOUISVILLE, KY 40285 -6176 11itiiI I i111 1i111r1n1n1i1it I I iiIi��
Ev��yd�e o Credit Card Account NatlonalClty.com /Card Services
w y Make payments, review transactions and more!
Rewards
At Your Service 2417: 800- 558 -8472 Mail payments to: National City
P.O. BOX 856176, LOUISVILLE, KY 40285.6176
Account Summary
Previous Balance $
Rewards Summary
Previous Earned This Month Issued This Month Current
56.54 19.55 0.00 76.09
Transactions
TranDate PostDate Reference Number Description Debits Credits
�.'.+eFtTY xr°''..a� v� _ti. dx. .3, ',�RI. X73.,. ,'it +�..�';':?e1�:
2415802DO47WH2JNYV IVY TECH TH DIST LEARN ING812- 2982325 IN 524.68
1 7 16 080124 Page 1 of 2 5624 9600 VEVM OIAN5170 22043
Grades Page 1 of 1
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Grades
Lenze, Theodore A
2008 SPRING
To choose another Term, choose Select Term from either the Term navigation bar or in the SITE MAP.
The deadline for instructors to post final semester grades online for the following semesters are:
Spring 2008 Friday, May 16, 2008 Summer 2008 Friday, August 9, 2008
Attempted Earned Quality Quality
Section Course Title Grade Hours Hours Hours Points GPA
ANP 101 -113A ANATOMY PHYSIOLOGY 1 C 3.00 3.00 3.00 6.00
Current Term 3.00 3.00 6.00 2.000
Cumulative through 2008 SUMMER 48.00 30.00 111.00 3.700
Instructions for obtaining your official transcript
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Any problems or comments call the SOS Helpdesk at 1- 877 -IVY -TECH or W ort the problem online.
Admissions_ Office I Bursars Office I Registr..a...r's Office I Fina..ncial Aid Office I Disability_Su..ppo.rt_Services I Career Services
RELEASE: 1.20
https://web4.iN-ytech.edu/ia-bin/tsrvweb 6/3/2008
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