Resource Guide - Texas Workforce Commission

TEXAS WORKFORCE COMMISSION
Career Schools and Veterans Education
Sample Refund Worksheet
Residence School
Appendix 24
Instructions: We suggest you use this form to calculate allowable refund charges, and to include it in the student’s
file. You must have all of the supportive documentation listed on page 2 readily available; and we encourage you
to attach copies of that documentation to this Refund Worksheet in the student’s file.
School #__________School Name _____________________Date of this Refund Calculation ____________
Student’s Name _______________________________________Student’s SSID # _____________________
Student’s Address _____________________________________ City/State/Zip ________________________
Student’s Phone #_______________________________ Refund Computed By ________________________
Type of funding (circle applicable) LOAN, GRANT, CASH, SPONSORED (by_______________________)
Course_________________________________________ Total Clock Hours in Course (1) _______________
(Use separate Refund Worksheet for each Course) or (2) _______________
Fee $________ Tuition (1) $________ or (2) $_________
Other Charges if separate from Tuition $ _______
Enrollment Date _______________First Day of Attendance ___________ Last Day of Attendance _________
Hours Scheduled Per Day _______ Days Scheduled Per Week _______ Termination Date ________________
Computation Data:
Has the student completed more than three weeks of training?________ If not, how many weeks? __________
1. Hours Attended __________
2. Hours Absent ___________
3. Scheduled Hours _________ (how many hours scheduled through the last day of attendance)
4. Total hours scheduled for the current year __________
5. Percent scheduled hours completed __________% (Total of #3 divided by total of #4 multiplied by 100)
(1) Course hours and costs should reflect totals adjusted for credit given for previous education and training if applicable.
(2) Clock hours are for the current year. Charge for each year independently. The length of a course, for purposes of
calculating refunds owed, is the shortest scheduled time period in which the course may be completed by continuous
attendance of a full-time student.
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PS-1040
PREVIOUS EDITIONS OF THIS FORM WILL NOT BE USED REV 03/04