HEET Grant Funds Request Form

SEIU 1199NW Healthcare Training Fund

Welcome to the SEIU Healthcare 1199NW Multi-Employer Training and Education Fund!

This form is for eligible HEET grant participants to request funds which directly support needs related to HEET grant efforts. 

Hospital Employee Education and Training (HEET) Grants are partnerships between labor, management, and academia which enhance access to college pathways for healthcare employees. HEET grants seek to strengthen partnerships and increase diversity in the healthcare workforce. Your Training Fund is proud to offer support for your academic journey!
Complete this form to request reimbursement for HEET childcare, technology, and/or transportation costs. Contact your Training Fund education navigator if you have any questions (https://healthcareerfund.org/about-us/staff-directory/).

Childcare Costs

Transportation Costs

Technology Costs

Other Education Related Costs



I certify that the amount requested was for eligible expenses incurred while in a HEET education program (during class, study, and/or tutor time, and not while working). I can access documentation to prove these expenses if requested.

I understand the use of these services may be audited. If I can't show documentation matching the amounts claimed, I commit to repaying the Training Fund for any improper funds received. Delays in repayment may affect future Training Fund funding.

I understand that HEET funds are considered taxable income. I am required to submit a W-9 form to the Training Fund, and if I receive $600 or more from the Training Fund within in a given year, I will receive a tax form to use when submitting my annual taxes. Please note: Training Fund staff are not tax professionals; please consult a tax professional for tax assistance.

I understand the amount I will receive will vary depending on funds available, total amount of requests submitted, and my participation in a HEET Grant related education program.

SEIU 1199NW Training Fund | 15 S. Grady Way, Suite 321 | Renton, WA 98057 | (425) 255-0315 | www.healthcareerfund.org | members@healthcareerfund.org