Career Counseling Network Reimbursement Form Instructions:

Career Counseling Network Reimbursement Form

Instructions:

Please use this form to request Staff Training Assistance Program (STAP) fund reimbursement for Career Counseling Network ONLY.

STAP fund reimbursement is limited to $500 per fiscal year for CCN services.
Please submit this form within 20 days of your CCN session date.
Reimbursements may take up to 10 business days to process.

Questions?

CCN reimbursement: Submit a HelpSU ticket
CCN program: Email learningdev@stanford.edu

The University policy regarding STAP is outlined in the Administrative Guide, Section 2.1.12: Staff Development Programs.

Employee Information

First Name*

Last Name*

Employee ID/University ID*

To locate:

Login to StanfordYou
Click Maintain your directory and AlertSU emergency contact information

SUNet ID*

To locate:

Login to StanfordYou
Click Maintain your directory and AlertSU emergency contact information

Email Address*

Phone Number*

Phone

School or Business Unit*

Select

Reimbursement Request

Total Reimbursement Requested*

Enter total in US Dollars.

Total STAP fund reimbursement is limited to $500 per fiscal year for all CCN services.
Reimbursement for career assessments may not exceed $175 out of the total $500 reimbursement limit.

CCN Career Counselor*

Select

Number of CCN Sessions*

For how many CCN Sessions are you requesting reimbursement?

Select

Session #1

Session #1 Date*

Session #1 Type*

30-Minute Session ($87.50)

1-Hour Session ($175)

90-Minute Session ($262.50)

Career Assessment (Enter amount in field below)

Career Assessment #1 Amount*

Enter amount in US Dollars.

Reimbursement for career assessments may not exceed $175 out of the total $500 reimbursement limit.

Session #2

Session #2 Date*

Session #2 Type*

30-Minute Session ($87.50)

1-Hour Session ($175)

90-Minute Session ($262.50)

Career Assessment (Enter amount in field below)

Career Assessment #2 Amount*

Enter amount in US Dollars.

Reimbursement for career assessments may not exceed $175 out of the total $500 reimbursement limit.

Session #3

Session #3 Date*

Session #3 Type*

30-Minute Session ($87.50)

1-Hour Session ($175)

90-Minute Session ($262.50)

Career Assessment (Enter amount in field below)

Career Assessment #3 Amount*

Enter amount in US Dollars.

Reimbursement for career assessments may not exceed $175 out of the total $500 reimbursement limit.

Receipt*

Upload receipt for CCN services on CCN Career Counselor's letterhead.

Drag and drop files here or

Confirmation*

I confirm that:

I have available STAP funds to cover my full reimbursement request.
I have not exceeded the $500 per fiscal year reimbursement limit.

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