Va Enrollment Form
Download a blank fillable Va Enrollment Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Va Enrollment Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2MADISON COLLEGE VETERANS SERVICES
VA Enrollment Form
INSTRUCTIONS - Complete this form if you are a:
• New Student- Never previously used veterans educational benefits.
• Transfer Student- Received benefits previously at an institution other than Madison College.
• Student Changing Chapters- Received benefits while attending Madison College but are now using a different chapter.
• Guest Student- Working towards a degree and receiving benefits at another institution.
This form must be completed and submitted to Veterans Services along with a copy of your DD214(s) and any additional
required documentation indicated below, unless previously submitted, to allow Madison College to certify your benefits.
STEP 1 - STUDENT INFORMATION
Last Name
First Name
Middle Initial
Date of Birth (
)
Email
dd/mm/yyyy
Mailing Address
City
State
Zip Code
When will you begin attending Madison College?
Fall
Spring
Summer
Year
Which type of student will you be?
New Student
Transfer Student - Submit a Change of Program Form (VA Form 22-1995 for Veterans, or VA Form 22-5495 Survivors/
Dependents) to the VA online using the VONAPP.
Student Changing Chapters
Guest Student - Submit a letter to Madison College Veterans Services from the parent school indicating that credits taken at
Madison College will be applied towards completion of a degree.
STEP 2 - BENEFIT INFORMATION
Have you applied for your veterans education benefits?
Yes - Submit your Certificate of Eligibility upon receipt to Madison College Veterans Services (you will receive your certificate
by mail from the VA approximately 3-4 weeks after completing the application).
No - Submit your application online at the VONAPP website (vabenefits.vba.va.gov/vonapp). All veteran students must
apply online for their initial benefits or to change their program/place of training.
Which benefit will you be receiving?
Chapter 1606 - Reserve/National Guard
Chapter 1607 - REAP Activated Reserve/Guard
Chapter 30 - Active Duty/Montgomery GI Bill® (MGIB)
Chapter 31 - Vocational Rehab - By selecting this chapter and submitting this form, you give permission for Madison
College to release your class schedule, grades and GPA to your Vocational Rehabilitation counselor.
Chapter 33 - Post 9/11
Chapter 35 - Survivors/Dependent Benefit - SSN of veteran:_____________________________________
VRAP- Veterans Retraining Assistance Program
Did you enter the military as a Wisconsin resident?
No
Yes
No
Are you on Active Duty?
Yes
Part 3 - ADVANCE PAY (Chapters 30, 1606, 1607 and 35 ONLY)
Do you want to receive advance pay?
Yes
No
• Advance Pay must be requested at least 45 days prior to the start of the semester. Only new students are eligible for Advance
Pay; continuing students and Chapter 33 - Post-9/11 recipients are ineligible.
• Advance Payments will pay for the first two months of the semester; students will not receive another VA educational benefit
check until the end of the third month of the semester.
Page 1 of 2
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business