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HomeMy WebLinkAbout170049 03/18/2009 CITY OF CARMEL, INDIANA VENDOR: 00351721 Page 1 of 1 0 ONE CIVIC SQUARE JAMES PAGE CHECK AMOUNT: $3,120.00 CARMEL, INDIANA 46032 CHECK NUMBER: 170049 CHECK DATE: 3/18/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1202 4128000 3,120.00 TUITION REIMBURSEMENT I i arMeS "QTY. C ,a. T I 4; 3 0 S o co CL o � y W W2 DATE AUTHORIZATION SUB 0 a (O/ ALP ZO I TOTAL y REFERENCE NO. SERVER TAX V ID- FOLIO/CHECK NO./UC. NO. STATE I REGJDEPT. CLERK TIP MISC. SIGN HERE 3 K W 1Q 0 agc c.� 'he issuer d the card idendfled on mie hem Is aumo tl, ythe artaunt shown as TOTAL Won proper preeerdafbn. I promise W pe each TOTAL (top�etlier whh erry other cha s due nereon> and lnaa«mn�e wlm t9ua gwemina me use 0 cer CUSTOMER: RETAIN THIS COPY FOR YOUR RECORDS r 1/2/09 04:34 pm Martin University Final Grade Report Term: FA -08 James E Page Student ID 404 -78 -3334 3961 N Broadway Indianapolis IN 46205 Phone: (317) 924 -9367 College Level Masters Degree Program URBAN MINISTRY STUDIES Advisor SITYNE, O'NEAL t UMS 562 50 Afr -Am Theology and Theologians 3.01 B 1 3.0 9.0 UMS 572 50 Urb Experience /Clergy Lay Leaders 3.0 A 3.0 12.0 Term: 6.0 6.0 6.0 21.0 3.500 100.0% Cumulative: 18.0 18.0 18.0 69.0 3.830 100.0% NOTE: If you need to have the school seal affixed for legal purposes or for tuition reimbursement, please bring the grade report to the Registrar's Office. TUITION COST /PAYMENT FOR THE SEMESTER OF: �MARTIN� ttvrvERStz" N /R k STUDENT _T L SSN t ADDRESS I A CITY STATE ZIP EMPLOYER 7�j C Ct�C �YGC�ty #qWW #kW #W ##4 #WW#WWW #WWWWg4 THE ABOVE NAAgD STUDENT PROMISES TQ PAY MARTIN UNIVERSITY FOR THE COST OF T NDQNCE CONSISTING OF CLASSES, (Q CREDIT HOURS g d0 PER CREDIT HOUR THIS WILL TOTALS E PLUS FEES. NOTE: INDI ATFI) WITH 4A7 4CTFRICK ARE NOT aecr VDABr c TUITION COST: s s FEES: *ADMISSION FEE SCIENCE /COMPUTER/MUSIC LAB *STUDENT ACTIVITY FEE *COMPUTER LAB USAGE FEE s� *SAFETY AND PUBLIC SERVICE FEE ipp,pp *LATE REGISTRATION FEE *GRADUATION FEE s OTHER DISCOUNT TOTAL DUE: TOTAL AMOUNT DUE MUST BE PAID ON, OR BEFORE RESPONSIBILITY FOR PAYMENT RESTS ENTIRELY WITH THE STUDENT, AND THE STUDENT WILL PAY ANY, AND ALL EXPENSES INCURRED IF COLLECTION EFFORTS ARE NECESSARY. A 30% COLLECTION FEE WILL BE ADDED TO ANY BALANCE THAT IS SENT TO A COLLECTION AGENCY. GRADES, TRANSCRIPTS, RECOMMENDATIONS, OR OTHER ACADEMIC SERVICES WILL NOT BE PROVIDED IF THERE IS AN UNPAID BALANCE ON THE STUDENT'S ACCOUNT. THE STUDENT'S SIGNATURE ATTESTS TO HIS /HER UNDERSTANDING OF THE ABOVE COSTS, FEES, PAYMENT DUE DATE, D CHARGES /E ENSES FOR NON- PROFIT. STWEW DATE COLL REPRESENTATIVE DATE uWWWw* *FOR COLLEGE USE ONLY *wW ##uWWWwW #WUwwwwgwW #qwu COMMENTS: *MANDATORY FEES PAID BY EVERY STUDENT, EVERY SEMESTER 171 AVONDALE PLACE BOX 18567 INDIANAPOLIS, IN 46218 (317) 543 -3235 FAX (317) 543 -4790 �y Y 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.) Emplovee Name Department TJOr 4) t/,5 8*7� 1 / Name of Course dt44V 4 EX Q1' ;&A1Gc 2 fUJ' (f �eay Starting Date of Course (month %daviyear) Z(' 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 reimbursement payments is subject to federal law. which may change from time to time. Employee Signature Date 13 2006 Part II (to be completed by Department Head) (Submit to Human Resources) By signin_T below_ I certify that the applicant will have been employed full -time ov the Ciry for at least one i 1) year prior to the commencement of the course. and has not been subject to a disciplinary suspension or demotion within 90 days prior to the beginning of the course. The Final claim will be paid Tom my department's budget. subject to the I f Section 2 -59 of Carmel Cite' Code. Department Head SiLmature pate Q VV Part I 'be comple by Director of Human Resources) Final approval �Ci•�1r•r� (r Date If denied. reason for denial The tuition reimbursement program covers only Cull- semester courses offered throuuh a decree- ssrantine 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 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 Mwp�, Z�_ Aa Department ��,t��r�. S�!5fc�rYl SSN Educational Institution* Name of Course l Starting Date of Course (month/day /year) 20 d� 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 reimbursement payments is subject to federal law. which may change from time to time. Employee Signature Pat-ko_ Date ZO 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 department's budget, subject to the terms of Sectio .2 of Carmel City Code. Department Head Signature Date 3 Q Part III (to be com by Director of Human Resources) Final Approval c/` Date 6 aS b 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. 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 James Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 03/03/091 Tuition Reimbursement 00 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 VOUCHER N®3 NO. ALLOWED 20 IN SUM OF $3,120.00 ON ACCOUNT OF APPROPRIATION FOR GENERALFUND 1202 Information Systems Board Members PO# or DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or 1202 28 0 n 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 Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund