Publix Reimburse Form – Fill Out and Use This PDF

(pursuing an associate’s or bachelor’s degree)

Instruction

For a class to be considered for reimbursement, send the following to the Tuition Reimbursement department within 45 days of class completion:

•a completed copy of this form

•a copy of your grade report and

•an itemized receipt (showing a breakdown of your tuition cost for each class and the method/s of payment).

Once your request is processed, you’ll receive an email at the address you provided in PASSport and from your immediate supervisor/manager. If you do not receive an email within four weeks, please contact us.

Tuition reimbursement department

If you have Tuition Reimbursement Program questions, visit www.publix.org > Career and Self Development > Tuition Reimbursement Program or contact us.

Address: Publix Super Markets, Inc.

Human Resources/Tuition Reimbursement Program P.O. Box 407

Lakeland, FL 33802-0407

When contacting us, please provide your Publix personnel number (located on your pay statement).

School you attended

Declared major*

Expected graduation month and year

Is this your last course before graduating?

YesNo

**Tuition expenses paid for with grants or scholarships will not be reimbursed.

Reimbursement criteria: To be eligible to receive reimbursement, you must

•be a current and approved Tuition Reimbursement Undergraduate participant on the date that your classes ended

•pursue a qualifying major at a regionally accredited school

•be an active associate with at least six months of consecutive service since your last hire date

•maintain a minimum average of 10 work hours per week based on a 52- week average or entire employment if employed less than one year

•maintain a minimum Total Performance Rating of Meets Expectations on your performance evaluation

•receive a grade of “C” or better in the class and

•be an active Publix associate on the date funds are disbursed.