Free Tuition Reimbursement Forms

This Tuition Reimbursement Request Form is for use by an employer who reimburses tuition for its employees. This request sets forth the employee’s name, employment status and the details surrounding the tuition. This reimbursement request also asks if the courses are related to the employee’s job duties. This Tuition Reimbursement Request Form must be signed and dated by the employee.

Disclaimer:This was not drafted by an attorney & should not be used as a legal document.

Tuition Reimbursement Request Form

Employee Details
Employee Name: ____________
Phone Number: _____________
Address: __________________

Employment Details
Job Title: __________________
ID: ________________________

Tuition Details
Name of School: _____________
Course: _____________________
Credit Hours: _________________
Course Begins: _______________
Course Ends: _________________
Tuition, Fees __________________
Name of Diploma/Degree: __________
Major Field of Study: ______________

How does the proposed course of study relate to your job assignment/position duties? ______________________
If the course meets during your normal work hours, how will your work schedule be adapted? ___________________
How will the course-provided knowledge/techniques improve your performance and be useful to the company? ___________________
I have read and understand the Tuition Reimbursement Policy and agree to the terms of the policy.

Employee Signature: ______________

Date: ________________________

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