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Continued VA Benefits Request Form
This form must be completed each semester that you would like to use VA Education benefits. All courses reported to VA must be requirements of your degree program.
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First Name
*
Your answer
Last Name
*
Your answer
NMC ID
*
Your answer
Email Address
*
Your answer
Phone
*
Your answer
Semester for VA Benefits
*
Choose only one semester after completing your registration. This is the semester you are requesting your enrollment be reported to VA for use of your VA Education Benefits.
Spring 2024
Summer 2024
Fall 2024
Previous semester not listed
I do not wish to be certified
Chapter
*
Chapter 30 Montgomery
Chapter 31 Vocational Rehabilitation
Chapter 33 Post 9/11 (includes transfer CH 33 benefit)
Chapter 35 Survivor's and Dependent Educational Assistance Program
Chapter 1606 Select Reserve
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