TUITION APPLICATION

This packet contains information that will assist you in applying for Tuition Assistance.

Please find enclosed:

—Tuition Assistance Program Summary

—FAQs

—Application Packet Checklist

—Application Form

—Manager Recommendation Form

—Request for Tuition Assistance Form

—Work Agreement (attached separately)

PLEASE MAIL, FAX, E-MAIL or HAND DELIVER YOUR COMPLETED APPLICATION PACKET

TO HUMAN RESOURCES:

Saint Thomas Health Services

Attention: Patty Matney

4220 Harding Road

Nashville, TN 37205

(615) 222-2859 Office

(615) 222- 4480 Fax

Allow 45 days for processing

Tuition Assistance Program Summary

What? / Saint ThomasHealth Services Tuition Assistance
Who? /
  • Associates must have been employed by STHS for at least 6 months before applying for tuition reimbursement.
  • Any full- or part-time benefits eligible associate may be considered. (Not PRN)
  • Associates must be in good standing and not currently involved in any disciplinary process to receive reimbursements.
  • Must have received an overall performance rating of achieves or exceedsin most recent performance review

When? / Applications can be submitted any time during the year and Human Resources will notify associate of the decision. Please allow 45 days for processing.
How Much? / Undergraduate Coursework:
$2625.00 per 6 month period
6 month period is defined as July 1st – December 31st and January 1st – June 30th
Not to exceed current IRS limits of $5250.00 per year.
Graduate Coursework:
$2625.00 per 6 month period
6 month period is defined as July 1st – December 31st and January 1st – June 30th
Not to exceed current IRS limits of $5250.00 per year.
Work
Agreement? / Commit to work for at least 12 months following completion of course of study.
Covered
Study / Approved and accredited academic programs

Frequently Asked Questions

What Must I Do?

  • Commit to work for Saint Thomas Health Services at least 12 months following completion of course of study.
  • Complete application packet(see under How do I Apply for more detail)
  • Maintain a grade point average of 2.5 for undergraduate studies and 3.0 for graduate degree programs (on a scale of 4.0).
  • Achieve an overall performance rating of “Exceeds”or “Achieves” on most recent performance review
  • Must be in good standing and not currently involved in any disciplinary process.

When do I apply?

We accept applications any time during the year. Please allow 45 days for processing.

How do I apply?

Go to Lifenet, go to Departments, Human Resources, then click on Tuition Assistance Program. The application packet, work agreement, tuition assistance policy and all other forms will be located here.

Application Process Steps:(Allow 45 days for processing)

  1. Complete application packet (See Application Packet Checklist on page 6)
  1. Ask your manager to review the application. If the manager approves the application they will fill out the Manager Recommendation Form, sign the Request for Tuition Assistance Form and turn the entire completed packet into the Vice President of the area. If they do not approve, the manager will give the application back to the associate and explain why it was not approved.
  1. The Vice President of the area will then review the application, if the VP approves the application they will sign the Vice President Recommendation Form and return the application to the manager. If they do not approve the VP will give the manager back the application and will explain why it was not approved and the manager will in turn explain to the associate why it was not approved.
  1. Once all approvals are received the manager will give the application back to the associate who will then turn it into Human Resources for final approval.

Mail, fax, e-mail or hand-deliver your COMPLETE APPLICATIONPACKET– to Human Resources. Fax: 615-222-4480 or e-mail:

How may I use the funds awarded?

Tuition Assistance funds may be used for tuition, fees and books. Funds may not be used to purchasecomputers, scanners, printers, etc.

How do I access my award?

STHS will reimburse you for tuition cost, fees and books up to the approved amount after course completion. Your course grades, a copy of your billing statement from the school (not credit card statement) together with Form B must be submitted within 30 days after course completion to the Human Resources Department.

When do I receive my reimbursement?

Your reimbursement will show up on your paycheck. It will be processed on the next payroll run after you submit the required documentation.

How much reimbursement can I receive and when?

For Undergraduate & Graduate Coursework:

  • $2625.00 per 6 month period
  • 6 month period is defined as July 1st – December 31st and January 1st – June 30th
  • Not to exceed current IRS limits of $5250.00 per year.

Why do I need to sign a new work agreement?

Beginning January 1, 2012, the work commitment will change from 24 months to 12 months which means that your work commitment will begin 12 months from the date that you receive your last tuition payment. If your last tuition payment was received prior to December 31, 2011, your 12 month work commitment will begin on January 1, 2012.

Tell me more about the 12-month work commitment following graduation.

You are asking for tuition assistance to help cover the expenses of furthering your education. We are pleased to be able to lighten the financial burden of this process for some STHS employees. In return, we ask you to commit to continue to work for Saint Thomas Health Services in a budgeted position of at least 20 hours a week for 12 months after you graduate or complete your course of study. Your work commitment begins on the date that you receive you last tuition payment from STHS.

If you are offered a position that is relevant for the degree we help to fund, but refuse to accept that position, you will be considered in default of your work agreement and responsible for repayment of any balance of your work agreement.

What about summer school?

If funds are still available for the fiscal year you can apply them to summer school before June 15th.

What if my GPA falls below the minimum?

If you do not maintain a 2.5 for undergraduate or 3.0 for graduate program grade point average, when you submit your grades to Human Resources, your tuition assistance funds will be suspended until your GPA has improved. When your GPA has improved, resubmit your grades to Human Resources and your funds will then be available.

What happens if I can’t attend school as expected?

All tuition assistance funds must be used in the fiscal year awarded. If you decide not to proceed with your education you must notify Human Resources as soon as possible.

Can I apply for tuition assistance if I am receiving a Foundation scholarship from the hospital?

Yes. The tuition assistance program is separate from the Foundation scholarship program. We encourage you to apply to both.

Associates must be in good standing and not currently involved in any disciplinary process to receive reimbursements. What does this mean?

If the associate is currently on a Performance Improvement Plan or on Probation they are not be eligible for tuition assistance. If the associate has received a written warning or been suspended in the last 90 days they are not be eligible for tuition assistance.

Application PacketChecklist:

Required Documents: (all of the below documents must be submitted in order for your application to be processed)

Completed tuition assistance application

One page essay about how the degree will benefit you and the hospital

Manager recommendation form

Vice President recommendation form

Copy of the course curriculum for your program

Signed Work Agreement

STILL HAVE QUESTIONS?

Please contact Patty Matney at 222-2859 or

Allow 45 days for processing

New Applicant Application for Tuition Assistance Program

Today’s Date ______

Associates Name______

Address______Street City State Zip

Home Phone______

Work Phone ______

E-Mail Address ______

Social Security Number______

Associate Number ______

Hospital (Circle one) STHBPHMTMHCKSTHS (NSC)

Job Title______Full or Part Time (circle one)

Dept/Unit/Office______

Managers Name ______

Date of Employment ______

Degree Pursuing: ______

University/College Name and Location ______

Projected Graduation Date______

A.All Applicants In one page or less (typewritten) explain how thesefunds will benefit you and, in turn, how it will benefit our hospitals. Please attach a separate sheet.

B. All Applicants Manager Recommendation form

C. All Applicants Vice President Recommendationform

D. All Applicants. I understand that I am obligated to fulfill a Work Agreement with Saint Thomas Health Services if I am awarded Tuition Assistance. The work commitment will begin from the date of the last reimbursement. The length of the work commitment is 12 months (1 year) for degree programs.

I understand that I must pay back any funding received if I default on the terms of this agreement. Examples of default include the following:

  • I quit school or do not complete my degree.
  • I change my major to one that is not funded through the Tuition Assistance Program.
  • I do not work in a budgeted position of at least 20 hours per week during and after school.
  • I am offered a position that is relevant to my degree but I refuse to accept the position.
  • I leave employment with Saint Thomas Health Services prior to completion of my work agreement.

I hereby state that the information given by me in this tuition assistance application is true in all respects. I agree that if I receive tuition assistance and the information on this application is found to be false in any respect, I will be subject to full repayment of any monies received as a result of this application.

SignatureDatePrint Name

All forms should be sent to Patty Matney: STH or Human Resources using in-house mail envelopes. You may also fax this form to 615.222.4480 or e-mail .

Please allow 45 days for processing.

Manager Recommendation Form

Tuition Assistance Recommendation for ______

(Applicant name)

I fully support this associate in his/her educational goal and recommend him/her for a consideration to receive tuition assistance from Saint Thomas Health Services. This associate is in good standing and has not received disciplinary action and is not under a work improvement plan.

Comments:

______

Manager’s signaturePrint Name

______

Date

______

DepartmentPhone

All forms should be sent to Patty Matney: STH or Human Resources using in-house mail envelopes. You may also fax this form to 615.222.4480 or e-mail .

Please allow 45 days for processing.

Vice President Acknowledgement Form

Tuition Assistance Recommendation for ______

(Applicant name)

I fully support this associate in his/her educational goal and recommend him/her for a consideration to receive tuition assistance from Saint Thomas Health Services. This associate is in good standing and has not received disciplinary action and is not under a work improvement plan.

Comments:

______

Manager’s signaturePrint Name

______

Date

______

DepartmentPhone

All forms should be sent to Patty Matney: STH or Human Resources using in-house mail envelopes. You may also fax this form to 615.222.4480 or e-mail .

Please allow 45 days for processing.

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