[Firm Name]

Advanced Education Program Application Form

 

TO REQUEST ACCEPTANCE INTO THE ADVANCED EDUCATION PROGRAM, PLEASE COMPLETE

THIS REQUEST FORM, SIGN THE AGREEMENT SECTION, AND ROUTE TO YOUR MANAGER.

 

Candidates accepted to participate in this program must meet the following participation standards:

 

§         Continue to exceed expectations in their work performance.

§         Continue to maintain a minimum 40 hour work week.

§         Maintain a “B” average or better.

 

Continuing participation in the program will be evaluated on a semester-by-semester basis based on the above criteria.  Upon meeting the above participation standards, participants will receive 75% of tuition and fees reimbursed by [Firm Name] at the completion of each semester upon submitting a transcript of grades.

 

APPLICANT                               Name  

INFORMATION                       

                                                     Course  

                                                     (Attach a copy of the program outline)

 

                                                     Date(s)                                                        Location         

 

Why do you feel [Firm Name] would benefit from your taking this advanced education program?

 

 

 

 

 

ESTIMATED                              Course Registration Fee                                   $

COSTS                                        Estimated Travel, Hotel and Other Expenses     $

                                                          TOTAL ESTIMATED COSTS                   $

 

REIMBURSEMENT                  I agree that if I voluntarily terminate my employment with [Firm Name]

AGREEMENT                            within one year of the above program date, I will repay the firm on a pro rata

                                                                      basis for any course where CPE course costs are $1,000 or more.  Course

                                                                      costs include registration fees, travel and other expenses.

 

DISCLAIMER                            [Firm Name] will make every effort to work with the participating professionals in scheduling work assignments and travel to accommodate both the needs of the client and the needs of the professional.  However, it is ultimately each participant’s responsibility to keep up with their schedule to meet both work and education requirements.  Participants may need to schedule vacation or other time off to accommodate study schedules, exams, and the like.

 

                                                    

                                                               Associate’s Signature                               Date