HomeMy WebLinkAbout167901 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 359600 Page 1 of 1
ONE CIVIC SQUARE HELEN BALLINGER
CHECK AMOUNT: $200.00
CARMEL, INDIANA 46032 12913 CURRIER STREET
CARMEL IN 46032 CHECK NUMBER: 167901
CHECK DATE: 1/21/2009
CEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4128000 200.00 TUITION REIMBURSEMENT
Carm e Clay
Parks &Recreation CHECK REQUEST
Date:
Check payable to 99
Name:
Address: /a 11,3 (,vrrler �'f
City, State, Zip Clcr'�' e--
V Mail check to payee Return-check to requestor
00
Check Amount QUO Date Required S 1,q -70
Check needed for I u 7-7 6 lV
To be paid from
PO (if applicable)
Budget account GL �d �r�s— a Boo 0
Budget Line Description �Yl J�ei rn b yr s e -r-�
Invoice(s) and Purchase Order (if required) MUST be attached.
Requested by (print): a f�v S
Requested by (signature):
Approved by (signature of Division Manager):
i
on this date y j 0
Form revised 7 -7 -08 Shared Administrative Forms Staff forms Check Request (rev 7 -7 -08)
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Helen Ballinger
ses Academic Planning My Academics Grades
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Fall 2008 1 Undergraduate 1 IUPUI change t erm
v Class Grades Fall 2008
Official Grades
K lass Description Units Grade Grade Points!
50C -R 315 POLITICAL SOCIOLOGY 3.00 A 12.000
SOCIOLOGY OF DEATH
SOC -R 327 3.00 A 11.100 I
I DYING
Term Statistics Fall 2008
From Combine l Cumulative)
i Transfer Termi
nrollment Total)
E
Credits Total
Tot at Grade Points 23 100 23 100 95 100;
Graded units towards GPA 6.000 6 000 24.6001 Graded units not for GPA i 97,000
In progress units j
3
1 GPA 3.850 3.850 3.963
GPA Total Grade Points Graded units towards GPA
Transfer Credit column information reflects the Transfer, Test and Special /Other Credit for
this term.
Statistics represent the grade points and hours as evaluated by the academic policies of
your academic school /program.
Go to "My Academics Grades" to run an Indiana University unofficial transcript to view
your Indiana University GPA and Hours in addition to your Student Program statistics.
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User Preferences Payment made by Helen Ballinger
View Accounts Confirmation Number: 2876008
Make Payment
Date Aug 19, 2008 at 5:07 PM EDT
Transacti story. Effective Date: Aug 20, 2008
i Primary User Id: 0001844572 I
Primary User Name: Helen Ballinger 111
Account: Indianapolis
Amount: $1,551.32
Cardholder's Name: Helen I
Payment Me th o d:
Address Info 12913 Currier Street
Carmel, IN 46032
Contact Info: (317)514 -0514 (daytime phone)
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Carmel 0 Clay
Parks &Recreation
Tuition Reimbursement Application Form
Part I (to be completed by employee)
(Please print. Subm it completed form to Supervisor prior to commencement of course.)
Employee Name I �ilti U.� 1 /'L
Department 1 5 S �CrVl �5 SSN � Hire Date J'� 4— a
Education Institution
Name of Course �p�� TI (,A L�OC fOoj�j 215
�'T
Semester/Year of Course A f±-L- Zoo S
I understand that to receive reimbursement for this course, 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. The amount of the
reimbursement is subject to the outlines in the Personnel Policy Handbook adopted by the Carmel /Clay
Board of Parks and Recreation. 4
Employee Signature Date
Supervisor Signature p Date
Part II (to be completed by Assistant Director)
(Submit to Human Resources)
By signing below, I certify that the applicant will have been employed full -time by the Carmel Clay
Parks and Recreation Department 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 outlined in the Personnel Policy Handbook.
Asst Director Signature Date 9
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.
*An application will not be considered complete unless a course description from the school's literature is attached.
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As requested, here is the course description for:
Current Course Offerings
Archived Course Offerings SOC
I R315
I
Other Course Listings Political Sociology
Special Course Listings i 3 cr.
Distance Education
Foreign Languages P: R100 or consent of instructor. Analysis of the nature and
basis of political power on the macro level —the community, the
Related national, and the international arenas. Study of formal and
IUPUI Course Description informal power structures and of the institutionalized and
Campus Bulletin noninstitutionalized mechanisms of access to power.
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Acco I,Status Account: Indianapolis Account Actions: Select Action t1-
Most Recent Statement
Statement History This information is accurate up to Fri, Aug 29, 2008 at 2:36:37 PM, EDT
Make Payment C Balance $72.25
Transaction History Current Activity
08/19/2008 Parking Permit 72.25
08/19/2008 Payment by Web Credit Card 1,551.32 CR
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1--1---, 9 To pay by check, click on "Printable Statement," print the Account Statement, detach the bottom portion and
Account Status mail it along with your check to the address on the statement.
Most Recent Statement
Statement History
NOTE: A "Previous Balance" appearing on this statement was due on an earlier Due Date. If the previous
Make Payment balance was paid, it will be reflected on this statement. Any amount not paid is considered past due and payable
Transaction History immediately. The Due Date on this statement does not apply to any amount previously due. Please refer to your
"Statement History" for previous balance details and due dates.
Account: Indianapolis Account Actions: Select Action
Printable Statement
Statement Date 08/06/2008 Due Date 08/19/2008
Invoice ID IN BILL# XXX1257599 Previous Balance 0.00
University ID 0001844572 Minimum Due 4,668.68 CR
Name Ballinger,Helen Total Due 4,668.68 CR
Statement notification sent to hiballin @iupui.edu
Statement Details
i
Charges and Adjustments
07/11/2008 Activity Fee 88.34
i 07/11/2008 Technology Fee 177.10
07/11/2008 General Services Fee 20.00
07/11/2008 Resident Undergraduate Fees 1,959.30
07/11/2008 Athletic Development Fee (SAF) 38.57
07/3012008 Activity Fee 19.89 CR
07/30/2008 Technology Fee 59.00 CR
07/30/2008 Resident Undergraduate Fees 653. CR i
Total Charges and Adjustments: 1,551.32
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
359600 Ballinger, Helen Terms
12913 Currier Street
Carmel, IN 46032
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
115109 Reimb Tuition reimbursement 200.00
Total 200.00
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 No. Warrant No.
359600 Ballinger, Helen Allowed 20
12913 Currier Street
Carmel, IN 46032
In Sum of
200.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #(TITLE AMOUNT Board Members
Dept
1125 Reimb 4128000 200.00 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
12 -Jan 2009
Signature
200.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund