177726 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 00353099 Page 1 of 1
J ONE CIVIC SQUARE JOHN JOKANTAS CHECK AMOUNT: $990.00
p CARMEL., INDIANA 46032 CIO COMM CENTER
CIO COMM CENTER CHECK NUMBER: 177726
CHECK DATE: 9129/2009
DEP ARTMENT PCCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
1115 4128000 990,00 TUITION REIMBURSEMENT
Receipt Statement
Page 1 of I
LE�A P
Leadership Education
for Adult Professionals
IMMISM Student ID: 1660766
INDIANA WESLEYAN UNIVERSITY Date 17 -SEP -2009
DIV. OF ADULT PROF. STUDIES
1900 W. 50T11 ST.
MARION. IN 46953
Student Name
JOKANTAS, JOHN M
634 W. 136TUI STREET
CARMEL, IN 46032
INVOICE
Start Date Invoice Number Description Inv Amt Discount Inv Total
07- OCT -08 BOOKS:52949I8 13ook -CRJ 467 90.00 0.00 90.00
RECEIPT
Date Receipt Number Payment Type Receipt Amt Amt Applied
22 -OCT -08 6721:208342 VISA <172.50> <90.00>
p tq r G h r, s eo G,.S t. G s C et, t
1
Total Invoice Balance: $0.00
TI.....4 f nM....o:.... I...E:...,.. \a/oola.,.... I I..:..o.r:r.,
R' Statement
i
L P Page I of 1
leadership Education
for Adult Professionals
MEM Student ID: 1660766
INDIANA WESLEYAN UNIVERSIT': Date' 17 -SEP -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
RECEIPT
Date Receipt Number Payment Type Receipt Amount Amt Applied
i4- SEP -09 6721:262466 VISA <900.00> <900 -00>
INVOICE
Start Date Invoice Number Description Inv Amt Discount Amt Applied
14- JUL -09 CRJ/467:5764708 RESEARCH METH ANALYSIS IN CRIMINAL 900.00 0.00 900.00
JUSTICE
Ccl( V1 rA, 4k
Receipt Balance: $0.0f
Thank you for choosing Indiana Wesleyan University,
City Of Carmel
Tuition Reimbursement Application Form
Part I (to be completed by employee)
(Please p rint. Submit completed form to Department Head ri f or to commencement of co rca
Employee Name T r rl f �'j 'U_C) 6 n 7�)
Department G a nol 14 17 r SS Hire Date V /vl "n.
Educational Institution �n f un c
Name of Course" t�e Se_ rc h (�71�ta r�� d� ��a /15 s Credit Hours 3
Starting Date of Course (month/day /year) ,s/ 7/ O 5
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 reimburspfnent pay i subject to federal law, which may change from time to time.
Employee Signature Date I 6
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 terrijs of Section 2;58 9 Carmel City Code.
Department Head Signature Date /G��i"
Part III (to be completed by Director of Human Resources)
Final Approval Date E C
If denied, reason for denial
Tie tuition reinibu'rsement prop -am covers oniv fuii- semnesie" courses offered tnurougii a degree granting institution
accredited b\- the North Central Association of Colleges and Schools or an equ*valent regional accreditor.
-A-t application not be considered complete unless a course description from the school's literature is attached.
i
DEPT NO. COURSE DESCRIPTION HOURS GRADE
INDIANA
f A A A T
E+ S LEY �i l �l CRJ -467 -A Research Methods and Analysis in 3.00 A
D V UNIVER�SI L I E Y V
RECORDS OFFICE
4201 South Washington Street
Marion, Indiana 46953
i
John M. Jokantas
1660766
07/14/09 08/17/09
I
i
HOURS TOTAL NON- QUALITY QUALITY QUALITY GRADE
SUMMARY ENROLLED EARNED HOURS HOURS POINTS POINT AVG.
I CURRENT
CUMULATIVE
63.00 123.00 0.00 60.00 239.10 3.98
a
H ONORS INFORMATION U
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 123 00 (min. 80 req.; 40 hrs. IWU) HONORS GPA 3.60
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
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VOUCHER NO. WARRANT NO.
ALLOWED 20
John Jokantas
IN SUM OF
634 W. 136th Street
Carmel, Indiana 46032
$990.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel CIS Communications
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1115 41- 280.00 $990.00 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
Monday, September 28, 2009
.e•-
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
09/28/09 I I 990.00
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