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 *
Last Name *
NMC ID *
Email Address *
Phone *
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.
Chapter *
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