Va Education Benefits - Rccc New Student Form printable pdf download

Va Education Benefits - Rccc New Student Form

School Certifying Officials

North Campus: Katie Herring

katie.herring@rccc.edu

704-216-3834

South Campus: Julie Goodman

julie.goodman@rccc.edu

704-216-3631

VA Education Benefits- RCCC New Student Form

Last:____________________________ First:______________________ Phone:___________________________

Address:___________________________________ City:_____________________ State:_____ ZIP:__________

VA File#:_____________________________ SSN:____________________________ DOB:__________________

Major:____________________________________ Email:______________________________________________

_________________________________________________________________________________________________________

Benefits Chapter (1-888-442-4551) Please circle:

1606 1607

1. Have you applied for VA education benefits?

Please circle:

Yes

If no, complete an application for benefits VA Form 22-1990 at

2. Have you ever used VA education benefits at another college?

Please circle:

Yes

If yes, you must submit VA Form 22-1995 at

3. Are you currently on active duty?

Please circle:

Yes

The following forms need to be submitted to your SCO before benefits can be certified:

_________ Certificate of Eligibility (received after applying for benefits)

_________ Application for Admission

_________ Your final schedule each semester

_________ Official High School transcript or GED certificate if applicable

_________ Official transcripts from ALL post-secondary institutions

Please list all post-secondary institutions attended:

_______________________________________

________________________________________

_______________________________________

________________________________________

Va Education Benefits - Rccc New Student Form