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Tuition Reimbursement Grant Application
First name
*
Last name
*
Email
*
Phone
*
Base School/Office
*
Position
*
College where coursework was taken or program attended to earn certification
*
Course for which you’re requesting reimbursement
*
Coursework Goal (select all that apply):
Completing an undergraduate degree in a content area or in education
Completing courses towards initial licensure
Completing coursework toward an endorsement in special education,
mathematics, sciences, or technology, library science or English
Language Learning
Other
Semester and year course was taken
*
Cost of tuition
*
Please upload the requested supporting documentation below.
Receipt of payment (bank or credit card statement)
*
Upload File
Proof of payment to the college/university (if applicable, this is found in your college/university SIS account)
*
Upload File
Transcript (unofficial transcripts are acceptable) with a passing score or program completion certificate
*
Upload File
Submit
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