You must be a full-time state employee, paid from the AA subsidiary, with at least six (6) months of full-time service, or equivalent part-time service, at the time you submit this certificate.
Certificates are to be completed in ink.
Proof of Marriage, like a Marriage Certificate, is needed if the Tuition Remission benefit is being used by your spouse. Your agency's Human Resources Director will verify the proof of marriage and write a description of the proof on the line provided.
Complete Sections I, II, and III. Section IV is to be filled out by your agency's Human Resources Director/designee. Section V is to be completed by your Agency Head/designee. All sections must be completed for the certificate to be valid.
Your Human Resources Director will return the authorized signed certificate to you. Keep a copy for your records. You must then submit this certificate with the tuition bill, or at the time of registration, to the Public Community College, State College, or University of Massachusetts campus you or your spouse will be attending.
This Certificate is valid for 120 days from the date of issue by your Agency Head/designee. A new certificate is required for each academic semester.
Please note: these forms are no longer sent to HRD for approval.
This information provided by the Human Resources Division