Corporate Alliance Professional Development Non-Credit Courses Tuition Reduction Form

Penn State at The Navy Yard offers tuition reduction for all graduate programs and courses to currently employed full-time and part-time employees of its Corporate Alliance Program member companies. Those students already receiving Penn State institutional scholarships or grants may not be eligible for the tuition reduction. This form must be completed within 7 days from course registration.

First Name

Middle

Last Name

Address

City

State

Semester

Summer

Fall

Spring

Course Abbreviation(s), i.e., BUSAD 501

Employee Status

Full-time

Part-Time

Company

Employment Verification and Educational Record Disclosure Agreement: By submission of this form I verify that I am currently employed by the company stated above. I understand that verification of my employment status must be submitted each semester that I enroll in courses with Penn State at The Navy Yard by completion and submission of this tuition reduction form. I will notify the Penn State at The Navy Yard within 14 days of any change in my employment status, and understand if I fail to provide notification, that I will be required to reimburse Penn State for any tuition discount received after my change in employment status. I authorize Penn State to provide educational record information to my company benefit administrator for purposes of invoicing and reporting including but not limited to courses taken, courses dropped, and financial records.