Employee Interest Form for Employer Tuition Assistance

* fields are required

Ready to upgrade your skills? Fill out the information below to get started!

Completion of this form does not guarantee tuition reimbursement at your place of employment. Please contact your company's Human Resources department for more information. Thank you!

First name: *

Last name: *

Email: *

Phone: *

Address: *

City: *

State: *

Zip Code: *

Have you attended Tri-C before?: *

Do you have prior college credit from another college/university?: *

What Tri-C campus is most convenient to you?: *

When do you plan to enroll at Tri-C?: *

Which courses/programs are you interested in learning more about?: *

Please specify: *

Name of company providing tuition reimbursement: *

How did you hear about Employee Benefit Programs?:

Please specify:

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