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Tuition Waiver Form 2014

 

 

 

 

 

MMA EMPLOYEE-DEPENDENT TUITION WAIVER

NAME OF EMPLOYEE: _____________________________ BARGAINING UNIT: _____________________

 

NAME OF DEPENDENT:____________________________  RELATIONSHIP: _________________________

 

IS THE DEPENDENT A FULL TIME STUDENT? YES             NO

 

IF YES, PROGRAM ENROLLED IN/DATE: ______________________________________________________

 

 

COURSES TO BE TAKEN: (if not full-time student) # Credit Hours in Course: Course Schedule: Days & Times 

 

 

 

 

 

I am the supervisor of the above named employee. By signing below, I approve of the proposed course schedule. I am aware that this course schedule will occur during the named employee's normal workday.  

 

PRINTED NAME: SIGNED: _______________________________________DATE:________________________

 

MMA DEPARTMENT CERTIFICATION:_____________________________________________________________

The Maine Maritime Academy Director of Human Resources certifies that the herein named employee, or dependent of an Academy employee is eligible to receive a tuition waiver or reimbursement as stipulated in the applicable MMS/MSEA union contracts. 

CERTIFIED AS (circle one) MMA EMPLOYEE---DEPENDENT

 

CERTIFIED BY: ___________________________________________ DATE: ___________________________

 

DISTRIBUTION:  HR    Finance  

 Employee   Financial Aid  

 Registrar or Continuing Ed  

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