Spring 2016 Request for Benefits
Last Name *
Your answer
First Name *
Your answer
SID# *
Your answer
Phone *
Your answer
Email Address *
Your answer
Street Address *
Your answer
City *
Your answer
Zip code *
Your answer
Degree Objective *
Major *
Your answer
2nd Major
Keep in mind 2nd major must be reported on Ed Plan
Your answer
Transfer School *
Which school do you intend on transferring to?
Which GI Bill are you utilizing? *
Are you requesting advanced pay? *
Only Ch. 30/35/1606 are eligible for Advanced Pay.
Will you pay the student health fee? *
Have you read and agree to adhere to the Standard of Student Conduct? *
I certify that all information is complete and correct. I agree to inform The Veterans Service Office of any changes in my enrollment status (adding/dropping certified class). I understand that failure to do so may result in me owing a debt to the Veterans Administration. *
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