Form TR-01.C

Textbook Reimbursement Form
Faculty/Staff Development Funding Program
Gainesville State College Foundation

Name__________________________________ Soc Sec Number _________-_______-_________




Semester _____________________ year____    Employed by____GSC	___Board of Regents




For Study at____________________________________for the following Professional
 

Objective or Statement of Job-related coursework plans    ______________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________


Courses________________________________________________________________________________ 
	                 Course Prefix &     Number	         Title		Hours of Credit

_______________________________________________________________________________________ 
	                 Course Prefix &     Number		 Title		Hours of Credit

_______________________________________________________________________________________
                         Course Prefix &     Number              Title          Hours of Credit

I certify that the courses I am taking this semester are job-related. If I am 
attending class during normal working hours, I have scheduled a make-up time with 
my supervisor.




Employee signature ___________________________ date ______________




Supervisor's Certification:




I certify that the courses the employee is taking this semester are job-related.  
If the classes meet during normal working hours, I certify that (1) employee's 
absence will not adversely impact departmental services or activities and (2) a 
schedule of times for make-up work has been established. 



Supervisor signature __________________________ date ____________



Employees who are not eligible for HOPE but who receive TRR qualify to receive Foundation Faculty/Staff Development funds in the form of a Textbook Reimbursement of $50.00. Employees 
taking coursework for credit are expected to apply for TRR before seeking Foundation Funds. These funds will be 
available after the employee has submitted all documentation (including grades for the academic period, and textbook
receipt(s)) to Coordinator of Professional Development. 
Date Reviewed__________________________ Amount $__________________________
Action___________________________________________________________________________________
Coordinator of Professional Development
signature _____________________________________ date__________________________
Distribution: employee, supervisor, Coordinator of Professional Development, GSC Foundation.