Employment Verification and Educational Record Disclosure Agreement: By submission of this form I verify that I am or my spouse/partner is currently employed by the company stated above. I understand that verification of employment status must be submitted each semester that I enroll in courses with Penn State Great Valley by completion and submission of this tuition reduction form. I will notify the PSGV Bursar Office within 14 days of any change in my or my spouse/partner's employment status, and understand if I fail to provide notification, that I will be required to reimburse PSGV for any tuition discount received after my change in employment status. I authorize PSGV to provide educational record information to my company benefit administrator for purposes of invoicing and reporting including but not limited to courses taken, courses dropped, and financial records.