Tuition Reimbursement Form

Tuition Reimbursement Form

Please complete this form to request financial assistance for educational expenses related to professional development.

Employee Information

Name

    Employee ID

    Department

      Job Title

        Phone number

          Course Details

          Course Title

            Institution Name

              Start Date

                End Date

                  Total Tuition Cost

                    Reimbursement Request

                    Amount Requested for Reimbursement

                      Percentage Covered by Company

                        Payment Method

                          • Direct

                          • Deposit

                          • Check

                          Course Relevance

                          Brief Description of Course Relevance to Current Role

                            Expected Benefits to the Company

                            Approval

                            Supervisor Name:

                            Date:

                            HR Name:

                            Date:

                            Reimbursement Form Templates @ Template.net

                            Thank you for your submission!

                            We appreciate you taking the time to submit.

                            Create free forms at Template.net