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JCU Employer Reimbursement Application & Participation Agreement
Name
Banner ID
Country
Street
City
Region
Postal Code
Telephone
Email
Which semester would you like to enroll
Which semester would you like to enroll
Spring 2026
Summer 2026
Fall 2026
Spring 2027
Tuition and Fees
Semester Tuition & Lab Fees
Amount Due Now or upon ERP Program Registration
Amount Due Four Weeks from last day of final exams
Documentation
Please upload a letter from your employer stating the terms of the company’s tuition reimbursement policy
and your participation in the company’s program.
Terms and Conditions
Terms and Conditions (Retain this portion for your records.)
Enrollment in the Employer Reimbursement Program: The student must provide each item:
Completed and signed Application and Participation Agreement. (this form)
Pay the non-refundable application fee of $10.00.
A letter from your employer stating the terms of the company’s tuition reimbursement policies and your participation in the company’s program.
Payment Terms: 33% of the semester’s total tuition and lab fees must be paid as billed by University. Students who register after the due date must pay at the time of registration. Final payment is made within four weeks of the last day of final exams for the semester of enrollment. (See front panel for due dates.)
Late payment Fee: Late payments will be assessed a $150.00 late fee.
Changes: Participant must furnish the Cashier a written notice of any change in the number credit hours taken.
Timely Payment: The participant is required to remit full and timely payment to the University regardless of the employer’s failure to comply, change of employment or other change of circumstances.
Availability: The Employer Reimbursement Program is available to part-time students.
Participation: Failure to comply with any of the Terms and Conditions will prevent the student’s further participation in the Program.
Semesters: The Employer Reimbursement Program is available fall, spring and summer semesters.
I have read and agree to the terms and conditions of the Employer Reimbursement Program and wish to
enroll in the Program for designated semester. I understand that failure to comply with these terms will prohibit my further participation in this program.
Electronic Signature
Submit