Human Resources


Employee Tuition Remission Application

* Required information
Employee Information: *
Full Name: *
Department: *
Email: *
Home Address: *
City: *
State: *
Zipcode: *
Work Status: *
Payment Type: *
Employment Type: *
Effective Date: *  
Date of Hire: *  
First time applying for benefits? *
Are you currently using benefits? *
If Yes, for whom?
NOTE: Please list all who are receiving benefit, including yourself.
Have you used beneftis in the past? *
If Yes, for whom?
NOTE: Employee must be receiving a paycheck from the College during the term in which taxable benefits are being used.
Student Information
Student's Name: *
Student ID#: *
Address: *
City: *
State: *
Zipcode: *
Relationship to employee: *
NOTE: Must be legal dependent to qualify.
Birthdate (if dependent):  
Have you been accepted to BW? *
If No, you are not eligible; reapply when accepted.
If Yes, what's your start date?
Are you applying for the 2015-2016 academic year? *
What are you applying for? *
Please indicate your education level as of this term: *
Select one or more of the following:
 Liberal Arts
If you checked Other specify here or your application will be rejected.:
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