EmailMe Form - FACULTY QUALIFIED TUITION REDUCTION PROGRAM (QTR)

FACULTY QUALIFIED TUITION REDUCTION PROGRAM (QTR)

All Faculty and Administrative staff may participate in the Qualified Tuition Reduction Program. Ma'ayanot can set aside up to 25% of your compensation before taxes and pay it directly to an educational institution. Eligible payments may be for yourself, your spouse or your child to attend school starting at age 5 (kindergarten) through college. Graduate school tuition is ineligible.

This form must be submitted prior to receiving your contract. Your total QTR amount cannot be changed after your contract is written; adjustments for where payments are sent may be submitted in writing to the business office.

Employee Name *
First Last
Employee Email *
I elect to maximize my QTR (25% of Salary) *
Yes
No
Name of School to Receive QTR pmts(#1) *
Dollar Amount or % (School #1) *
If you enter a % in this box, the school will calculate the dollar amount as a % of total QTR
School Address (School 1) *

Street Address City State / Province / Region Postal / Zip Code Country / Region
Business Office Contact *
First Last
Email of School Business Office *
Name of Student (s) *
First Last
You may list multiple students here if you have more than one student in the same school
Student ID # (Optional)
Name of School to Receive QTR pmts(#2)
Dollar Amount or % of Total QTR
If you enter a % in this box, the school will calculate the dollar amount as a % of total QTR
School Address (School #2)

Street Address City State / Province / Region Postal / Zip Code Country / Region
Business Office Contact of School #2
First Last
Email of School #2 Business office
Name of Students(s) (School #2)
First Last
You may list multiple students here if you have more than one child in the same school
Student ID# (optional)
Name of School to Receive QTR payments (#3)
Dollar Amount or % of Total QTR (#3)
If you enter a % in this box, the school will calculate the dollar amount as a % of total QTR.
School Address #3

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email of School #3 Business Office
Business Office Contact of School #3
First Last
Name of Student(s) (School #3)
First Last
You may list multiple students here if you have more than one child in the same school
Student ID # (Optional)
The total amount of QTR benefit to be reflected on my contract and calculated as part of my compensation package equals:
$ Dollars
This amount should be the total of the all school amounts combined. Not to total more than 25% of entire compensation. Please round to a whole dollar amount (no cents)
Total Percentage (should equal 100%)
Special Instructions for Business Office regarding QTR payments: