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AEA Tuition Reimbursement Request Form
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Tuition Reimbursement Request Form
2021-2022 Teachers
If you are filing for tuition reimbursement, remember that this request pertains to graduate course work for the period covering July 1, 2021 through June 30, 2022. All reimbursement requests must be RECEIVED by May 3, 2021.
Requestor Name:
*
Work Location:
*
Andover High School
Bancroft Elementary School
Doherty Middle School
High Plain Elementary School
Sanborn Elementary School
Shawsheen Preschool
South Elementary School
West Elementary School
West Middle School
Wood Hill Middle School
TOPS
Email:
*
Graduate Program:
*
Type of Program:
*
Graduate
Doctoral
Other
College:
*
Enrollment Date:
*
Has the graduate program been approved by the Assistant Superintendent?
Yes
No
Course Title and Number:
*
Semester:
*
Summer 2020
Fall 2020
Winter 2021
Spring 2021
Per Credit Cost:
*
Number of Credits:
*
Total Amount to be Reimbursed: (entered amount can not exceed $1500)
*
Only will be reimbursed for one course up to 3 credits.
Comments:
* indicates required fields.
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