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ELIC RIVER 1VILINICIPAL UTILITIES <br />APPLICATION F'OIZ EDUCATIONAL ASSISTANCE <br />(EMPLOYEE MUST COMPLETE APPLICATION AND OBTAIN FULL APPROVAL <br />BEFORE REGISTRATION. REFER TO EDUCATIONAL ASSISTANCE POLICY.) <br />NAME <br />CURRENT JOB TITLE: <br />PREVIOUS EDiiCATiGN HISTORY: <br />PROPOSED COLLEGE /UNIVERSITY /TECHNICAL SCHOOL OR COURSE TO BE ATTENDED: <br />COURSE TITLE: <br />COURSE #: <br />START DATE: <br />COSTS: TUTION OR FEES <br />OTHER (please specify) <br />BOOKS <br />EXPLAIN VALUE OF COURSE TO YOU AND ELK RIVER MUNICIPAL UTILITIES: <br />ARE YOU ELEGIBLE FOR ANY OUTSIDE EDUCATIONAL ASSISTANCE (e.g. G.I. Bill, scholarship, <br />etc)? <br />I AGREE TO PAY ALL INITIAL COSTS OF MY COURSEWORK AND UNDERSTAND THAT UPON <br />FULL APPROVAL, ELK RIVER MUNICIPAL UTILITIES WILL REIMBURSE 100% OF QUALIFIED <br />COSTS WHEN SUPPLIED WITH RECEIPTS OF COSTS AND DOCUMENTATION OF SUCCESSFUL <br />COMPLETION. I FURTHER ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE <br />EDUCATION ASSISTANCE POLICY. <br />APPLICANT'S SIGNATURE <br />SUPERVISOR'S SIGNATURE <br />CREDITS: <br />COMPLETION DATE: <br />DATE <br />DATE <br />