ࡱ> 130g  bjbjVV 4"r<r< PP,GIIIIII$rBmmoooGoGooor5%vo30ooooommoP ^: CANKDESKA CIKANA COMMUNITY COLLEGE Employee Request for Course Approval and Waiver of Fees This form is used to request approval to enroll in courses for credit in accordance with the On Campus Educational Leave (FeeWaiver) Policy No. 388. INSTRUCTIONS: Please complete Sections I and II and forward to the Human Resources Office at least 3-5 business days prior to registration to ensure adequate time for processing. The approved form will be returned to you. You will be charged fees if you: 1) Do not complete the course or should you receive a grade lower than a C, and/or 2) Register for hours in excess of the fee waiver benefit and/or 3) Do not submit your transcripts at the end of each term. NOTE: You will be responsible for payment of fees if this form is not submitted prior to enrolling in courses. (The employees course of study must complement the employees work responsibilities). I. EMPLOYEEPlease complete this section as applicable. _________________________________________ __________________ __________________ Employee Name (please print) Employee No. SSN Distributions: _________________________________ _______________________ Program Percent of Effort _________________________________ _______________________ Program Percent of Effort I hereby request approval for waiver of______ (may not exceed 6) hours of credit during the (number) ____________________ term ___________ at the ԰. (Summer/Fall/Spring) (year) Course Title: ___________________________________________________ No. Credits: __________ Course Title:____________________________________________________ No Credits: ___________ Employee Signature: ___________________________________________Date: __________________ II. SUPERVISORPlease complete this section. _______I approve this request. ________ I do not approve of this request. Reason:_____________________________________ Supervisor Signature __________________________________________Date: ___________________ III. HUMAN RESOURCESComplete this section. Signature: ____________________________________________________ Date: __________________ cc: Personnel file Business Office August 2010 "#Z[\ 1 5 U X a f g = ^ _  øyqf^VNh6'CJaJhJYCJaJhG^CJaJh$h6$CJaJh\DCJaJh}CJaJh{+iCJaJh$ha 5CJ\aJh$h=bg5CJ\aJh$h=bgCJaJhwCJaJh$ha CJaJh6$h=bg5CJ\aJha 5CJ\aJh6$ha 5CJ\aJh6$ha CJaJh6$h=bgCJaJ#[\  L M ]   o 7$8$H$gdZ'$d7$8$H$Ngd6$ 7$8$H$gda $7$8$H$a$gd=bg 2 3    2 4 7 ? 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