Faculty Staff Tuition Benefit Form

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Faculty/Staff Tuition Benefit Form

Employee Name*

First Name

Last Name

Employee Title*

Name of student applying for benefit*

First Name

Last Name

Expected High School Graduation Date*

Hire Date*

Relationship to employee*

Benefit applying for*

Knox Tuition ACM tuition Tuition Exchange $500 reimbursement at a college other than Knox, ACM or TE

Approved by Human Resources?

Yes No

Year benefit applies to:

Comments

Date