166754 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 00353099 Page 1 Of 1
ONE CIVIC SQUARE JOHN JOKANTAS CHECK AMOUNT: $915.00
,a CARMEL, INDIANA 46032 C/O COMM CENTER
C/O COMM CENTER CHECK NUMBER: 166754
CHECK DATE: 1211012008
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4128000.;.: 915.00 TUITION REIMBURSEMENT
Ulu IPD
420i S WASHINCUTCh S T
DATE' ii/1 0 TIME: !6: 52 :38
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CIRDMEWR AC1tt�OblLCIiGES 1SECEIPT OF
GOPMS AMD/O� 'SERVICES IN HE f; UNIT OF
THE MAIL SRUM HE IKO'ii AND 06REES TO
PERFORM TH E SEI FOPTH UY ME
CAROMEMBER'S AGREENEEiT ►,IIT11 IHE:IS
TliAHK YOU FQR USIE1G VI:A
TOP G1?PY- MEtiCx{ MI BOTT111'1 CoPY••CUS TONER
DEPT NO. COURSE DESCRIPTION HOURS GRADE
INDIANA
W E CRJ -465 -A Constitutional Law /Civil Liberties 3.00 A-
UNI V �tE}R S »Il lII LT1Y�111
RECORDS OFFICE
4201 South Washington Street
Marion, Indiana 46953
John M. Jokantas
1660766
09/02/08 10/06/08
r SUMMARY HOURS TOTAL NON- QUALITY QUALITY QUALITY GRADE
ENROLLED EARNED HOURS HOURS POINTS POINTAVG.
�_N CURRENT
CUMULATIVE
2640 89.00 0.00 26.00 103.10 3.96
HONORS INFORMATION b
Indiana Wesleyan University Cumulative GPA reflects hours earned at Indiana Wesleyan University only. Calculation for Baccalaureate honors may include
is aChrist- centered transfer hours. Current status of Baccalaureate honors:
m
academic community GRADED HOURS 89.00 (min. 80 req.; 40 hrs. IWU) HONORS GPA 3.44
committed to
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.
B 3.0 Good NR No grade report given
and leadership. B- 2.7 CR Credit Equivalent to C or above
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 Unsatisfactory
http:// www. indwes .edu /records/transcripts.htm. IP In Progress
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RECEIPT
RECEIVED FROM: JQKAN1 JOHN M
634 W. 136th Street INDIANA WESLEYAN UNIVERSITY
Carmel IN 46032 Div. of Adult Prof. Studies
1900 W. 50TH ST.
MYkRION IN 46953
RECEIPT PRINTED: 11-NOV-08
REF: JOKANTAS, JOHN M
�XX-XXjdM
5$QJOL 06
RECEIPT DATE DESCRIPTION AMOUNT
I RbOKS'. Bo -CRJ465
07-NOV-08 90.00
CRJ/465:CONSTITUTIONAL LAW/CTVTL LIBERTIES
07-NOV-08 825.00
TOTAL RECB.IPT APPLIED 915.00
TOTAL UNAPPLIED RECEIPT 0,00
TOTAL AMOUNT RECEIVED 915.00
Please feel free to contact our office with any questions, our phone number is 1
-800-2 option ption 2. We have a new voice mail line that will allow you to re
quest receipts, statements, or invoices by dialing our 800 number and selecting
option 2 extension 3498. Thank you for allowing us to serve your educational ne
eds. Indiana Wesleyan LEAP Accounting Department.
dkf
City Of Carmel
Tuition Reimbursement Application Form
Part I (to be completed by employee)
(Please Print. Submit completed form to Department Head rim or to commencement of course.)
Employee Name o G;''1.
Department Lo t)� rn u n CcT(� SSN Date O
.Educational Institution 2 r
Marne of Course L O Y} (,1 j a L Z( tV
®.rl�
Starting Date of Course (montli/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 -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.
III 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 reimburse meets is subject to federal law, which may change from tine to time.
Employee Signature Date
]Part TY (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 40 days prior to the beginning of the course. The final claim will be paid from my
department's budget subject to the terms of Section 2759 f Carmel City Code.
Department Head Signature Date
Part IfZ (to be completed by Director of Human Resources)
Final Approval �R (;.qtr 1._r Date S Z, L
If denied, reason for denial
The tuition reimbursement program covers only frill semester courses olTered 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.
Rev June 07
V N 0. WAR RANT NO.
Jahn Jokantas ALLOWED 20
IN SUM OF
$915.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1115 41- 280.00 $915.00 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
Tuesday, December 02, 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)
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))
11/11/08 I I $915.00
1 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