SEA Prior Approval Form

Stamford Education Association

Prior Approval for Tuition Reimbursement

Please review guidelines here.

Employee ID

Employee ID (Last 5 digits from paystub)

Teacher Name*

Choose Semester *

Please select semester

Thursday Location *

Teacher City Email *

Per Article 20F of the contract, I hereby apply for prior approval for tuition reimbursement for the graduate course(s) listed below:

The following course represents a class...*

Course Number*

Course Title*

University/College*

Course Start Date*

Course End Date *

Credits *

Teacher Total Tuition Cost * $

Employee Signature *

Use your mouse or finger to draw your signature above

Today's Date

Human Resources Approval

Human Resources Approval*

Denial Explanation

Total $ Beyond Masters (PC)*

Total $ Beyond Masters (1/2)*

Total $ Leading to Masters (1/2)*

Total $ Leading to Masters (PC)*

Credits Remaining

For email to teacher

Tuition Expense

Processed by...*

Today's Date