Employee Scholarship Application/Authorization Form

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Texas A&M University at Galveston
Employee Scholarship Application
Fall _____ Spring _____
The mission of Texas A&M University at Galveston is:
Texas A&M University at Galveston is a special-purpose institution of higher education for undergraduate and
graduate instruction in marine and maritime studies in science, engineering and business and for research and
public service related to the general field of marine resources. The institution is under the management and
control of the Board of Regents of The Texas A&M University System, with degrees offered under the name and
authority of Texas A&M University at College Station.
As an institution of higher education, we have a core value to support lifelong learning for all. We desire to encourage
our employees to seek baccalaureate degrees to further enhance their professional capacities as well as our learning
environment, productivity and effectiveness.
To be eligible for a scholarship to cover enrollment in TAMUG classes, a TAMUG employee must:







Be a full-time employee with a minimum of 12 months of service.
Have a minimum performance rating of “Meets Expectations” on their most recent performance evaluation.
Have supervisor approval.
Be admitted to TAMUG as an undergraduate student based on published admission criteria.
Enroll in undergraduate classes only.
Comply with published policy regarding release time if classes are taken during the employee’s regular work
hours.
Be a Texas resident.
The scholarship will be provided for a maximum of four semester credit hours during the Fall or Spring terms, based on
the schedule below. This schedule includes basic costs but does not include laboratory or field trip fees; employees will
typically cover these costs individually.
Total Cost – 1112 Cohort
Current Waiver
Health Center Fee
Student Center
Rec Center
TOTAL SCHOLARSHIP APPLIED – 1112 Cohort
Total Cost – 1213 Cohort
Current Waiver
Health Center Fee
Student Center
Rec Center
TOTAL SCHOLARSHIP APPLIED – 1213 Cohort
3 SCH
1012.56
4 SCH
1316.58
40.50
40.00
20.00
40.50
40.00
20.00
912.06
1216.08
3 SCH
1023.70
4 SCH
1331.06
40.50
40.00
20.00
40.50
40.00
20.00
923.20
1230.56
Total Cost – 1314 Cohort
Current Waiver
Health Center Fee
Student Center
Rec Center
TOTAL SCHOLARSHIP APPLIED – 1314 Cohort
Total Cost – 1415 Cohort
Current Waiver
Health Center Fee
Student Center
Rec Center
TOTAL SCHOLARSHIP APPLIED – 1415 Cohort
Total Cost – 1516 Cohort
Current Waiver
Health Center Fee
Student Center
Rec Center
TOTAL SCHOLARSHIP APPLIED – 1415 Cohort
3 SCH
1035.00
4 SCH
1345.76
40.50
40.00
20.00
40.50
40.00
20.00
934.50
1245.26
3 SCH
1046.47
4 SCH
1360.67
40.50
40.00
20.00
40.50
40.00
20.00
945.97
1260.17
3 SCH
1160.94
4 SCH
1483.75
40.50
40.00
20.00
40.50
40.00
20.00
1060.44
1383.25
Texas A&M University at Galveston
Employee Scholarship Application Authorization Form
Fall _____ Spring _____
To be eligible for a scholarship to cover enrollment in a 3 or 4 hour TAMUG class a TAMUG employee must:







Be a full-time employee with a minimum of 12 months of service.
Have a minimum performance rating of “Meets Expectations” on their most recent performance evaluation.
Have supervisor approval.
Be admitted to TAMUG as an undergraduate student based on published admission criteria.
Enroll in undergraduate classes only.
Comply with published policy regarding release time if classes are taken during the employee’s regular work
hours.
Be a Texas resident.
NAME: ____________________________________________________________________
UIN: _________________________________
Telephone: __________________________
EMPLOYEE SCHOLARSHIP AUTHORIZATIONS
SUPERVISOR:
The employee must have supervisor approval to take class.
As the supervisor, do you approve?
YES
/
NO
_________________________________________________
Signature
______________________
Date
HUMAN RESOURCES:
The employee must be a full-time employee with a minimum of 12 months of service, must have a minimum
performance rating of “Meets Expectations” on their most recent performance evaluation, and must comply with
published policy regarding release time if classes are taken during the employee’s regular work hours.
Does the employee meet these requirements?
YES
/
__________________________________________________
Signature
NO
_______________________
Date
ADMISSIONS:
The employee must be admitted to TAMUG based on published admission criteria, may enroll in undergraduate classes
only, and must be a Texas Resident.
Does the employee meet these requirements?
YES
/
___________________________________________________
Signature
FINANCIAL MANAGEMENT SERVICES:
The employee must complete an employee waiver.
Has this waiver has been completed?
YES
/
______________________
Date
NO
___________________________________________________
Signature
Do you currently have a baccalaureate degree?
YES
NO
_______________________
Date
/
NO
Intended Course? ______________________________________________________________________
Please provide a brief explanation of your educational goals and how this course relates to your goals or your current
position:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
_____________________________________
Employee Signature
__________________________
Date
Your signature above will above authorizes TAMUG to verify you have completed the above requirements.
The scholarship will be provided for maximum of four semester credit hours a semester. The scholarship will cover basic
tuition and fee costs, but does not include field trip fee. Employees will cover these costs individually.
APPLICATION DEADLINE – January 25, 2016.
THE AUTHORIZATION AND APPLICATION FORM SHOULD BE FORWARDED TO THE OFFICE OF SCHOLARSHIPS WHEN
COMPLETE.
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