164785 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 00353099 Page 1 of 1
d ONE CIVIC SQUARE JOHN JOKANTAS CHECK AMOUNT: $915.00
CARMEL, INDIANA 46032 C/O COMM CENTER
CEO COMM CENTER CHECK NUMBER: 164785
CHECK DATE: 10116/2008
DEPARTMENT ACC OUNT PO NUM INVOICE NUMBER AMOUN D ESCRI PTI ON
r 1115 4128000.: 915.00 TUITION REIMBURSEMENT
77
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3 -A Forensics 3100 A
s
Antto �"a�4�?d,ti�:c;� ��?{v'S: 43r 1 'C4�':
79
T W.. T
i
}k HOURS TOTAL NON QUALITY QUALITY QUALITY GRADE
'rn ENROLLED EARNED HOURS HOURS POINTS POINTAVG.
it
V 23.00 86.00 0.00 23.00
AT
Lp Xwi i} &E. ry E 1, ri t t CIF iGPA reflects hours earned at Indiana Wesleyan University only. Calculation for Baccalaureate honors may include
5
uF'P. Q I T,E11.,Im 1 ma ors. Current status of Baccalaureate honors:
HE T I L A N yI N 3
q�t,rTl j. 1 DUBS 86.00 (min. 80 req.; 40 hrs. IWU) HONORS GPA 3 44 H
f.;RF0 Ii H i L', i{ L'ff�sF4E I 1t1T1 i ��1 3
rt t i C f_
ALL ERRORS MUST BE REPORTED WITHIN TWO WEEKS.
r 3 'F.iff s�t' I �1 5 `.�cF: ii
ON OF GRADES, POINTS, AND CREDIT HOURS THE UNIT OF CREDIT ISTHE SEMESTER HOUR.
Excellent WF Withdrawal while failing Grade point average based on quality points
1p1 t7us[i i'R W Withdrawal while passing divided by quality hours. Total earned hours
I Incomplete count toward graduation requirements.
��a,kk t .3�y A Good NR No grade report given
r CR Credit Equivalent to C or above
T l i NC Non Credit Equivalent to below C
i t Jt fs•J// Average AU Audit
NA Failure to Audit
0 Outstanding
Passing S Satisfactory
Failure U Unsatisfactory
http:l/www.indwes.edu /records /transcript's.htm. IP In Progress
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RECEIPT
RECEIVED FROM: JOKANTAS, JOHN M
14703 Strauss Dr #1924 INDIANA WESLEYAN UNIVERSITY
Carmel IN 46032 Div. of Adult Prof. Studies
1900 W. 50TH ST.
MARION IN 46953
RECEIPT PRINTED: 29- SEP -08
REF: JOKANTAS, JOHN M
XXX-XX- 06
RECEIPT DATE DESCRIPTION AMOUNT
BOOKS:Book -CRJ 463
25- SEP -08 90.00
CRJ /463:FORENSICS
25- SEP -08 825.00
TOTAL RECEIPT APPLIED 915.00
TOTAL UNAPPLIED RECEIPT 0.00
TOTAL AMOU�?T RECEIVE? 915. 00
Please feel free to contact our office with any questions, our phone number is 1
800 -234 -5327 option 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.
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City Of Carm el.
Tuition'Rei ursenient 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 C 0 m nt u n C a4� o n S SSN � Hire Date
Educational Institution* r ,Z eS 1�x q
Name of Course j s.
Starting Date of Course (month/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.
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 t ayments is subject to federal law, which may change from time to time.
Employee Signature.. Date Q r1 03
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 :t6 the beginning of the course. The final claim will be paid from my
department's budget, subject to the to ectio -59 of Carmel City Code.
Department Head Signature li- yam` Date 7- 1
Part III (to be completed by Director, of Human Resources)
Final Approval e� Date 7 7 0
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.
Rev June 07
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))
09/29/08 I 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
VOU WARR NO.
ALLOWED 20
John Jokantas
IN SUM OF
7219 Registry Drive
Indianapolis, Indiana 46217
$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
Thursday, October 09, 2008
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund