This form should be submitted after registering for classes.
First Name
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Last Name
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CWID
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E-Mail
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Address If address has not changed within the last year, leave blank.
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Phone #
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I expect to receive VA Educational Benefits from the following chapter:
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Enter the hours that you are enrolled in for theFall Semester.
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Choose your status
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What is your major?
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Are you currently on Active Duty?
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Do you have or expect to receive an ROTC scholarship?
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Are you enrolled in any on-line courses?
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Are you repeating any courses?
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Are you graduating at the end of this semester?
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Do you expect to receive Federal Tuition Assistance (FTA)?
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Are you enrolled in any of the following? If you answer to any of the following, please check with the Veterans Coordinator for approval.
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If you have additional information that you would like to provide, please indicate in the space provided.
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If at any time during the enrollment period indicated above, I drop a course, withdraw from school, stop attending class, change my program, or change my status in any way, I will notify the Veterans Affairs Coordinator. I understand failure to notify the VA Coordinator of such changes could result in financial penalties. If the VA Coordinator determines a course is inappropriate for the degree program, I understand only those hours determined to be required for the degree will be certified. If the VA Coordinator determines a course is inappropriate, after drop/add, or after the free drop period, I understand a reduction in hours will automatically be forwarded to the Department of Veterans Affairs. Note: By submitting this form, I certify that I fully understand this information and agree to the conditions.
Academics
