CONTINUING EDUCATION REIMBURSEMENT

Ka'u Hospital Charitable Foundation offers reimbursements to employees of Ka'u Hospital for continuing education course tuition, exams and books. We proudly support hospital staff in advancing their careers by obtaining additional certifications, degrees and skill advancement. Up to a maximum of $500.00 per year is available per employee.

Qualification requirements:

Applicant must be an employee of Ka'u Hospital for at least 2 years and working no less than 20 hours per week.
Applicant must provide a letter of need from a supervisor or department head
Applicant must provide a receipt proving expense being reimbursed was paid by applicant (receipt must include applicant's name, vendor/institution to whom expense was paid, a description of what was purchased, the date of the purchase and the total amount paid)

Application for Reimbursement

First name

Last name

Phone

Physical Address

Mailing Address (if different than physical address)

Date of hire at Ka'u Hospital

Position / Title at Ka'u Hospital

Supervisor / Department Head's Name

Average Number of Hours per week worked in the last year

Type of reimbursement being requested

Description of reimbursement being requested.

Total amount of reimbursement request

Paid receipt(s)

Upload a copy of your paid receipt(s) here

Supervisor or Department Head letter

Upload a copy of your letter of need written and signed by your supervisor or department head here

I hereby certify that all information provided above is true and accurate and that I am an employee of Ka'u Hospital working no less than 20 hours per week.

Signature

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