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ELK RIVER MUNICIPAL UTILITIES <br />322 KING AVENUE <br />ELK RIVER, MINNESOTA SS330 <br />APPLICATION FOR EDUCATIONAL ASSISTANCE <br />(Ei-SPLOYEE MUST COMPLETE e~PPLICATION AND OBTAIN FULL APPROVAL <br />BEFORE REGISTRATION. REFER TO EDUCATIONAL ASSISTANCE POLICY) <br />I . Name <br />Current Job Title: <br />Previous Education History: <br />Proposed College/University/Technical School or course to be <br />attended: <br />Course Title: <br />Course No.: Credits: <br />DATES Start:. / / Completion: / / <br />COSTS Tuition or Fees: Books: <br />Other (Specify) <br />Explain Value of Course To You and Elk River Municipal Utilities: <br />Are You Eligible For Any Outside Educational Assistance (e.g. G.I. <br />bill, Scholarship, etc.)? <br />I AGREE TO PAY ALL INITIAL COSTS OF MY COURSE'n70RK AND UNDERSTAND THAT UPON FULL <br />APPROVAL, ELX IVER MUNICIPAL UTILITIES WILL REIMBURSE 1008 OF QUALIFIED COSTS <br />WHEN SUP~I,IED~RECEIPTS OF COSTS AND DOCUMENTATION 0~ SUCESSFUL COMPLETION. I <br />FURTHER ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE "EDUCATIONAL ASSISTANCE <br />POLICY" <br />APT T('ANT' S SIGNATURE DATE <br />cr*D~'gVISOR' S SIGNATURE DATE <br />