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Employee Benefit Application for Tuition Remission and Tuition Exchange
Application for benefits from August 1, 2021 - July 31, 2022. Academic Year 20-21 Deadline for application is October 20, 2020.
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* Indicates required question
Email
*
Your email
Employee's Name
*
Your answer
Employee ID Number
*
Your answer
Employee's Home Address
*
Your answer
Employee's Contact Information: Preferred phone and email address
*
Your answer
Augustana Start Date
MM
/
DD
/
YYYY
Employment Status
Full time
Part time
Other:
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If you have used either the National or ELCA Tuition Exchange in the past, please list the names of past dependents that have used the prgrams, which exchange was used, schools attended, and years of attendance.
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Is this a renewal application?
Yes
No
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