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HIGH SCHOOL TUITION RECIPROCAL REDUCTION APPLICATION FOR THE 2013/2014 ACADEMIC YEAR


A separate application is required for each dependent and must be completed each year. This application must be submitted by April 15, 2013, 4:30 p.m.


ELIGIBILITY REQUIREMENTS:  Full-time faculty and staff with three years of continuous, benefit eligible service completed on or before September 1, 2013.


I have read and understand the policy provisions summarized on this application.  The complete policy can be found at:
http://www.creighton.edu/hr/benefits/additionalbenefits/hsreciprocal/index.php
I, AGREE and ACCEPT the terms of the High School Reciprocal Program.

Employee Information:
FIRST NAME
LAST NAME
EMPLOYEE ID
NET ID
PHONE
EMAIL
DEPARTMENT

Dependent Information:
FIRST NAME
MIDDLE NAME
LAST NAME
DATE OF BIRTH
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Please check the student grade level for the 2013/2014 Academic Year:
7th (Saint Albert Catholic School)
8th (Saint Albert Catholic School)
Freshman
Sophomore
Junior
Senior

Please check the school for which you are applying for the High School Reciprocal discount:
Brownell-Talbot (grades 9-12 only)
Creighton Prep High School
Duchesne Academy
Gross High School
Mercy High School
Mount Michael High School
Roncalli High School
Saint Albert Catholic School (grades 7-12 only)
Skutt High School

Creighton Prep & Duchesne are offering a $1,000.00 discount.
Mercy High School is offering a 20% discount.
All other schools are offering a 25% discount
.
This online application will be reviewed by Human Resources for verification of eligible Creighton service.
Completion and approval of this form does not constitute academic authorization to any of the schools listed above. 


High School Reciprocal Reduction