Employee Student Loan Repayment Assistance

Employee Student Loan Repayment Assistance — Form Fields

This hr template includes 14 fields. Application for employee student loan repayment assistance benefit program. Free to customize and use on ZenBuild.

• Employee Name (text, required)
• Work Email (email, required)
• Employee ID (text, required)
• Department (text, required)
• Years of Service (number, required)
• Student Loan Servicer (text, required)
• Loan Account Number (text, required)
• Outstanding Balance ($) (number, required)
• Monthly Payment Amount ($) (number, required)
• Degree Obtained (dropdown selection, required) — options: Associate's, Bachelor's, Master's, Doctorate, Professional (JD/MD), Certificate Program
• Field of Study (text, required)
• Loans in Good Standing (multiple choice, required) — options: Yes, No - In Deferment, No - In Forbearance
• Requested Monthly Contribution (dropdown selection, required) — options: $50, $100, $150, $200, $250 (max)
• Loan Statement Upload (file upload, required)