174964 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 00353099 Page 1 of 1
ONE CIVIC SQUARE JOHN JOKANTAS CHECK AMOUNT: $2,196.00
CARMEL, INDIANA 46032 C70 COMM CENTER
C!0 COMM CENTER CHECK NUMBER: 174964
CHECK DATE: 712212009
DEPART ACCOUNT PO NU INVOICE NUMBER AMOUNT DESCRIPTION
1115 4128000 2,196.00 TUITION REIMBURSEMENT
j
1 1
INDIANA
W CRJ -309 -A Youth and Crime 3.00 A
UN I V E RS I T Y
RECORDS OFFICE
4201 South Washington Street
Marion, Indiana 46953
John M. Jokantas
1660766
04/28/09 06/01/09
HOURS TOTAL NON- QUALITY QUALITY QUALITY GRADE
SUMMARY ENROLLED EARNED HOURS HOURS POINTS POINT AVG.
CURRENT
CUMULATIVE
53.00 113.00 0.00 50.00 199.10 3.98
HONORS INFOR At ON
U
Indiana Wesleyan University Cumulative GPA reflects hours earned at Indiana Wesleyan University only. Calculation for Baccalaureate honors may include
transfer hours. Current status of Baccalaureate honors:
is a Christ- centered
academic community GRADED HOURS 11 3.00 (min. 80 req.; 40 hrs. IWU) HONORS GPA 3.56 3
committed to ALL ERRORS MUST BE REPORTED WITHIN TWO WEEKS.
changing the world
EXPLANATION OF GRADES, POINTS, AND CREDIT HOURS THE UNIT OF CREDIT IS THE 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
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City Of Carmel
Tuition Reimbursement Application Form
Part I (to be completed by employee)
(Please, trot, Submit completed form to Department Hea prior to commencement of rn�irgP
Employee Name
Department G C?Ol 1 k n rCS, f71 SSN Date 4�06.�
Educational Institution* -L17 a
Name of Course`* YO U4 I lam` 1Y1 C Credit Hours 3
Starting Date of Course (month day /year) Y/O� g Q
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.
o The tax status of reimburse ent aymen s is subject to federal law, which may change from time to time.
Employee Signature Date 1- A
Fart II (to be completed by Department Bead)
(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 Section 2 -58 of Carmel City Code.
Department Head Signature ee Date /C /Mw)
Fart III (to be completed by Director of Human Resources)
Final Approval Date a p
If denied, reason for denial
ire tuttton .rein�bt rseme t progra col e:s cni�° It -se:_ ester ccurscs offered throu -n a deTee g a :itinc institution
accredited by the North Central _association of Colleges and Schools or an eouivaler_t regional accreditor.
An application «ill not be considered coinplete u:aess a course description from: the schcol s literate -e is attached.
eceipt Statement
Page I of 1
L FEMMA P t
Leadership Eduction
for Adult Professionals
Student ID: 1660766
INDIANA WESLEYAN UNIVERSITY Date: 14-JUL-201.'.
DIV. OF ADULT PROF. STUDIES
1900 W. 50TH ST.
MARION. IN 46953
Student Name
JOKANTAS, JOHN M
634 W. 136TH STREET
CARMEL, IN 46032
INVOICE
Start Date Invoice Number Description Inv Amt Discount Inv Total
28-APR-09 BOOKS:5596130 Books-M 309 92.00 0.00 92.00
RECEIPT
Date Receipt Number Payment Type Receipt Amt Amt Appiied
08-JUN-09 EFr:060809 ALTERNATIVE LOANS <3,000.00> <92.00>
Total Invoice Balance: $0.00
Thank you for choosing Indiana Wesleyan University.
v RCC�I�t Sta�elIleht
LP Page 1 of 1
Leadership Education
for Adult Professionals
Student ID: 1660766
INDIANA WESLEYAN UNIVERSITY
Date: 14 -JUL -2009
DIV. OF ADULT PROF. STUDIES
1900 W. 50TH ST.
MARION, IN 46953
Student Name
JOKANTAS, JOHN M
634 W. 136TH STREET
CARMEL, IN 46032
INVOICE
Start Date Invoice Number Description Inv Amt Discount Inv Total
28- APR-09 CRJ1309:5596129 Youth and Crime 825.00 0.00 825.00
RECEIPT
Date Receipt Number Payment Type Receipt Amt Amt Applied
08 JUN 09 F,FT:060809 ALTERNATIVE LOANS <3,000.00> <825.00>
Total Invoice Balance: $0.00
Thank you for choosing Indiana Wesleyan University.
INDIANA _7 411
WESLEYAN
MGT 43 2 A Organizational Behavior 3.00 Ai
EINI VLRSITY
�1 RECORDS OFFICE
4201 South Washington Street
Marion, Indiana 46953
John M. Jokantas
1660766
04/16/09 05/20/09
f SUMMARY HOURS TOTAL NON- QUALITY QUALITY QUALITY GRADE
ENROLLED EARNED HOURS HOURS POINTS POINTAVG.
CURRENT
CUMULATIVE
50.00 110.00 0.00 47.00 187.10 3.98
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:
academic community GRADED HOURS 110.00 (min. 80 req.; 40 hrs. IWU) HONORS GPA 3.55 3
committed to ALL ERRORS MUST BE REPORTED WITHIN TWO WEEKS.
changing the world
EXPLANATION OF GRADES, POINTS, AND CREDIT HOURS THE UNIT OF CREDIT ISTH£ 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.
6 3.0 Good NR No grade report given
and leadership. 6- 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
httpJlwww. indwes .edulrecords/transcripts.htm. IP In Progress
1 If
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City Of Carmel
Tuition reimbursement Application Form
Part I (to be completed by employee)
(Please print. Submit completed form to Department Head prior to comtrl enccT7 e t of Course.) Employee Name T o t -t M k c� n `7 ,I
Department C 0M ryt o hJ SSN Hire Date 8 /0.�
Educational Institution` n
Name of Course" O Cgcr n e.41" n 4 1 6e Y14 vi f Credit Hours
Starting Date of Course (monthMay /year) V /aZ 3 Q 1
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.
d The tax status of reimbursement. payments subject to federal law, which may change from time to time.
Employee Signature Date 0
Part II (to be completed by Department Dead)
(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 Section 2 -58 of Carmel City Code.
Department Head Signature Date
Part III (to be completed by Director of Human Resources)
Final Approval Date 0
If denied, reason for denial
The tuition .reimburserne,.t prog:as, covers only iuli- sernester courses offered through deE granting institution
accredited by the North Central Assecia €ion. of Colleges and Schools or an equivalent regional accreditor.
An application ��ill not be considered complete unless a course descriptioc fro:; the school`s literartre is attached.
r
RelutSta
ec tement
Page 1 of 1
LENJAP 'i
Leadership Education
for Adule Piokssianals
Student ID: 1660766
INDIANA WESLEYAN UNIVERSITY Uate: 14- JUL -2V
DIV. OF ADULT PROF. STUDIES
1900 W. 50TH ST.
MARION. IN 46953
Student Name
JOKANTAS, JOHN M
634 W. 136TIJ STREET
CARMEL, IN 46032
INVOICE
Start Date Invoice Number Description Inv Amt Discount Inv Total
16 -APR, 09 BOOKS:5607578 Books -MGT 432 199.00 0.00 199.00
RECEIPT
Date Receipt Number Payment Type Receipt Amt Amt Applied
08 -JUN -09 EFT:060809 ALTERNATIVE LOANS <3,000.00> <199.00>
Total Invoice Balance: $0.00
Thank you for choosing Indiana Wesleyan University.
Receipt Statement
L ILm A P Page 1 of 1
leadership Education
for Adult Professionals
Student 1D: 1660766
INDIANA WESLEYAN UNIVERSIT'
Date: 14 -J UL -20EW
DIV. OF ADULT PROF. STUDIES
1900 W. 50TH ST.
MARION. IN 46953
Student Name
JOKANTAS, JOHN M
634 W. 136TH STREET
CARMEL, IN 46032
INVOICE
Start Date invoice Number Description Inv Amt Discount Inv Total
16 -APR -09 MGT/432:5607577 Organizational Behavior 1,080.00 0.00 1,080.00
RECEIPT
Date Receipt Number Payment Type Receipt Amt Amt Applied
08 -JUN -09 EFF:060809 ALTERNATIVE LOANS <3,000.00> <1,080.00>
Total Invoice Balance: $0.00
Thank you for choosing Indiana Wesleyan University.
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))
07/16/09 I I I $2,196.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
.John Jokantas
IN SUM OF
634 W. 136th Street
Carmel, Indiana 46032
$2,196.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1115 41- 280.00 $2,196.00 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, July 16, 2009
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund