Education Assistance Program Application Form

EMPLOYEE INFORMATION
( ) Completion of Undergraduate or Bachelor Degree
Employee Name (Last Name, First Name, Middle Initial) Employee ID Date of Hire

Current Position Program/Department Site Contact Number

Degree/s Obtained: ______________________________________________________ ( ) Graduated ( ) Unfinished

______________________________________________________ ( ) Graduated ( ) Unfinished

I would like to avail of the EDUCATION ASSISTANCE PROGRAM. Description of the course is as follows:
Degree/Course: School/Institution:
Date Course Begins (mm/dd/yyyy): Date Course Ends (mm/dd/yyyy):

A. Qualifications:
1. All regular employees are eligible for educational assistance of up to a maximum of Php25,000.00 per annum.
2. The chosen course/s must commence and be completed while the employee is still on ACTIVE status in Concentrix.
3. An employee who wants to avail of the EAP should be able to attend classes without any adverse impact in his/her work schedule
(i.e., he/she should ensure that his/her prospective class schedule does not coincide with current and future work schedules).
4. The employee must not be on a Performance Management Plan (PMP).

B. Courses Covered by EAP:

1. Educational Assistance will be provided only for enrolment in colleges/universities, business schools, IT Education Institutes that are
accredited by DECS and/or CHED or any industry-recognized reputable organizations.
2. The course may be any of the following degree and non-degree programs (Masters or Doctorate degree, Diploma or Certificate
Course,or Completion of an Undergraduate or Bachelors degree).
3. The course enrolled is a pass or fail course or it provides grades at the end of the course.
4. The course pursued must be related to an employee’s current role or a reasonable future role within Concentrix or;

SUPERVISOR'S ENDORSEMENT REQUIREMENTS

1. The employee is NOT under the Performance Management Plan (PMP).
2. The class schedule does not conflict with the employee’s work shift.  EAP Application Form
 Official Receipt (Original Copy)
_________________ _______________ _______________  Assessment Form (w/ breakdown of fees)
Immediate Supervisor Manager Senior Manager

C. Terms and Conditions:

1. Only school tuition fees will be covered by the EAP. Other fees such as books, uniform, newsletter and miscellaneous fees and the
like are not covered and can not be reimbursed.
2. The employee is required to submit proof of marks/grades attained within thirty (30) days upon completion of the course. The
employee shall not incur failing marks of the subjects enrolled at the end of the course.
3. The employee shall not incur a No Call/No Show (NCNS) or Unauthorized Absence, a Corrective Action Plan or be under a
Performance Management Plan (PMP) or BRIDGE, at any point during the course.
4. Failure to comply or meet any item of the Terms and Conditions will result to a reversal of the full amount of the educational
assistance given to the employee which will be implemented on the nearest payroll.
The employee may proceed for reimbursement once signed by the Supervisor. Attach the original O.R. and Assessment and submit to
HR within fifteen (15) days from the date of payment
I recognize that the Company shall reimburse me with the actual amount of tuition fees paid up to a maximum of Php25,000 only if I
remain in the Company’s employment within the duration of the course. If I resign or be separated from employment for any reason
whatsoever during the said period, I bind myself, and am indebted to pay the Company for the total amount of EDUCATION
ASSISTANCE reimbursed. For this purpose, I expressly authorize the Company to withhold and apply any amounts otherwise owed me
by the Company, whether in the form of salaries or otherwise, and apply the same to the payment of my obligation herein, without
prejudice to further collection by the Company if the amount so withheld and deducted is insufficient.

I affirm that the foregoing information is true and correct. I have read, and I understand and agree to the terms and conditions of the
Education Assistance Program. Concentrix may conduct audits, including verification of education institution attended, grades attained,
and tuition fees paid. I understand that I have to submit the official receipt within 15 days from date of payment otherwise; the
amount will not be eligible for reimbursement.
____________________________________
Employee's Signature over Printed Name

PRE-ASSESSMENT (FOR HR USE ONLY)

1. Regular Employee: ( ) Yes ( ) No PAYMENT DETAILS:

2. The course pursued is a:
Amount Paid: _____________ Date of Payment: ____________
( ) Masters or Doctorate Degree
( ) Completion of Undergraduate or Bachelor Degree Reviewed by:
( ) Diploma or Certificate Course
3. DECS/CHED Accredited School: ( ) Yes ( ) No _____________________________ ________________
Signature Over Printed Name Date
4. The course is related to an employee's current role or a
reasonable future role within Concentrix. ( ) Yes ( ) No Verified by:
5. The course is a pass or fail course or it
_____________________________ ________________
provides grades at the end of the course. ( ) Yes ( ) No
Signature Over Printed Name Date
Approved by:
Remarks: ( ) Pre-Qualified for EAP.
( ) Not Qualified for EAP. _____________________________ ________________
Reason:____________ Signature Over Printed Name Date