Submit Reimbursement Application

The Foundation will reimburse CGA member company employees up to $300 per course. Employees are limited to a maximum annual reimbursement of $2,400.

The applicant must have completed this course with a grade of C or better (or a certificate of completion for seminar courses). For individual courses, the Foundation will reimburse employees up to $300 for an “A”, up to $200 for a “B”, and up to $100 for a “C” or other passing grade (e.g. certificate, Pass, etc.).

To request reimbursement, submit the following information for each course independently along with a tuition receipt, evidence of completion, and verification of term ending date from the course provider. A book receipt is also required for those who qualify. An incomplete form or documentation results in the disapproval of the application.

A complete application must be received within two months of the term end date. A complete application includes supervisor’s approval, tuition receipt, verification of term ending date, and evidence of completion. NO EXCEPTIONS ALLOWED.

Employer must be a current member of the California Grocers Association. Employee must work a minimum of 16 hours per week to qualify for this program and must be employed with the qualifying company for 6 months.
Both Employee and Employer acknowledge the program is on a “first come, first served” basis. All applications will be evaluated by the Approval Committee in the order in which they are received. Approval is granted without regard to race, color, creed, religion, age, gender, disability, national origin, sexual orientation, or other protected status. It is possible that funds for this program may be depleted by the time this application is processed. The CGAEF Board of Trustees and the Approval Committee have the sole discretion to disapprove any application and reserves the right to limit the amount of funding to any one company or individual based on aggregate usage or available funds.

PLEASE NOTE: Your supervisor’s name and email address must be provided in the form below in order to process your application. Applicant is responsible for submitting accurate email address and notifying supervisor of required email confirmation.

"*" indicates required fields

Personal Info

Employee Name:*

Employment Info

Work Address:*

Course Info

(e.g. Intro to Marketing)
MM slash DD slash YYYY
MM slash DD slash YYYY
Why did you complete this course? (Check all that apply)*

Course Expenses

Exclude misc. fees, e.g., student, health, parking
Applies only to Retail Management Certificate Courses

File Uploads

Allowed files: JPG, PNG, OR PDF files ONLY

Max file size: 10 MB

Drop files here or
Accepted file types: jpg, png, pdf, Max. file size: 200 MB, Max. files: 1.
    Document must include applicant’s name, course title and course end date.
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    Accepted file types: jpg, png, pdf, Max. file size: 200 MB, Max. files: 1.
      Document must include applicant’s name, course title and proof of completion.
      Drop files here or
      Accepted file types: jpg, png, pdf, Max. file size: 200 MB, Max. files: 1.
        Document must include applicant’s name and payment information.
        Drop files here or
        Accepted file types: jpg, png, pdf, Max. file size: 200 MB, Max. files: 1.
          Document must include applicant’s name, book title and payment information.

          For Approval

          Acknowledgement

          By signing, I acknowledge that I have taken this course voluntarily and paid it with personal funds. Please enter your initials to sign:
          To transmit the application, click the submit button. Printed screenshots are not accepted. Following submission, an email request for approval will be sent to the applicant’s supervisor. Applicant is responsible for providing complete and accurate contact information. Failure to do so will result in application’s disapproval.