174923 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 132750 Page 1 of 1
ONE CIVIC SQUARE AARON HOOVER
CHECK AMOUNT: $817.00
CARMEL, INDIANA 46032 1301STAVE SW
CARMEL IN 46032 CHECK NUMBER: 174923
CHECK DATE: 7/22/2009
DEPARTMENT ACCOUNT PO NUMBE INVOI NUMBER AMOUNT D
651 5023990 817.00 TUITION REIM
City Of Carmel
Tuition Reimbursement Application Form
Part I (to be completed by employee)
(Please print. Submit coWleted form to D partment Head rip 'or to commencement of course.)
Employee Name cam✓
Department ,�}Qr- (�C no SSN 3O 0y' Date -1� 6
Educational Institution* ems^ an ✓ers
Name of Course C/7 2 Wedgy A- Wke dit Hours
Starting Date of Course (month/day /year) J 3-
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 -58.
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 an original itemized receipt
or other proof of purchase that links these books to this particular course.
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 yments is s ject to federal law, which may change from time to time.
Employee Signature Date
Part H (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 ftom my
department's budget, subject to the terms of S tion 2 -58 of Carmel City Code.
Department Head Signature Date t3y.. lloC�
Part III (to be completed by Director of human Resources)
Final Approval Q-- Q— Date
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.
1
Course Course
No. E Course Title Length Credits Books Fees* Tuition Total
Initial Deposit *$100.00
UNvi 11 Philosophy Practice of Lifelong Learning I 4 weeks 2 $102.00 $470.00
ENG140 Communications I 5 weeks 3 $140.00 $100.00 $705.00 $1,617.00
ENG141 Communications II 5 weeks 3 $0.00 $105.00 $705.00 $810.00
CITI 12 Intro. to Computer Information Technology 5 weeks 3 $90.00 $705 $795.00
PHE140 Concepts of Wellness 4 weeks 2 $64.00 $470.00 $534.00
BIL102 New Testament Survey 5 weeks 3 $49.00 $705.00 .$754.00
COM115 Introduction to Human Communications 5 weeks 3 $91.00 $705.00 $796.00
CIT220 Desktop applications 6 weeks 4 $104.00 $940.00 $1,044.00
HST180 Hlmlanities: World Civilization 5 weeks 3 $100.00 $705.00 $805.00
MAT108 Modern Concepts of Mathematics 5 weeks 3 $85.00 $705.00 $790.00
PSY155 Psychology of Personal Adjustment 5 weeks 3 $109.00 $705.00 $814.00
ENG242 Literature and Ideas 5 weeks 3 $98.00 $705.00 $803.00
CIT140 Operating Systems Concepts 5 weeks 3 $119.00 $705.00 $824.00
CIT120 Introduction to Programming Concepts 5 weeks 3 $47.00 $705.00 $752.00
MUS180 Humanities: Fine Arts 5 weeks 3 $140.00 $705.00 $845.00
PHL283 Philosophy and Christian Thought 5 weeks 3 $97.00 $705.00 $802.00
CIT262 Network Communications 5 weeks 3 $126.00 $705.00 $831.00
CIT260 Database Concepts 5 weeks 3 $99.00 $705.00 $804.00
CIT270 'E- Commerce and Web Development 5 weeks 3 $112.00 $705.00 $817.00
CIT2 Hardware and Software Troubleshooting 5 weeks 3 $137.00 $75.00 $705.00 $917.00
CIT280 Project Management and Integration Capstone 5 weeks 3 $105.00 $705.00 $810.00
TOTAL 62 $2,114.00 *$280.00 $14,570.00 $16,964.00
Tuition: $235.00 per credit hour *Educational Resource Fee: $205.00, Graduation Fee: $75.00
PAYMENT PROCESS
A. Deposit*
An initial deposit of $100.00 must be submitted to the Marion office. Payment may be mailed in or phoned in using VISA,
MasterCard, or Discover (if the class is full when your deposit is received, your name will be placed on a waiting list). Regardless
of how subsequent payments will be made (financial aid, veterans' benefits, etc.), the $100.00 deposit is still required.
B. Balance of First Payment
The remaining balance of your first payment for the first two courses must be received in the Marion office by noon 14
days prior to the class start, or your name will be dropped from the class list and you will be ineligible to start this session.
Late payments will not be accepted.
Direct Payment to:
Indiana Wesleyan University LEAP Office 1900 W. 50th Street Marion, IN 46953
800 234 -5327, option 2 765 677 -3265
Indiana Wesleyan University reserves the right to change information in this document without notice.
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RECORDS OFFICE l r +P
4201 South Washington Street
Marion, Indiana 46953
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.Aaron D. Hoover c
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7 SUMMARY HOURS TOTAL NON QUALITY QUALITY QUALITY GRADE
ENROLLED EARNED HOURS HOURS POINTS POINT AVG.
CURRENT x r G T-
jr
CUMULATIVE
56 .00`;f
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Indiana Wesleyan University Cumulative GPA reflects hours earned at Indiana Wesleyan University only. Calculation for Baccalaureate honors may include q
transfer hours. Current status of Baccalaureate honors:
is aChrist- centered O
m
academic community GRADED HOURS (min. 80 req.; 40 hrs. IWU) HONORS GPA
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 O 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
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
132750
AARON HOOVER Purchase Order No.
SEWER COLLECTION Terms
CARMEL, IN 46032 Due Date 7/13/2009 p
11
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/13/2009 072009 $817.00
D
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VGUCHER 095990 WARRANT ALLOWED
132750 IN SUM OF
AARON HOOVER
SEWER COLLECTION
CARMEL, IN 46032
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
072009 01- 7040 -01 $817.00
Voucher Total $817.00
Cost distribution ledger classification if
claim paid under vehicle highway fund