Va Class Schedule Form

UNCW Office of Scholarships Z Financial Aid

VA Class Schedule

This form must be completed each

term you intend to use VA benefits

Student IDI ______________________

Name ____________________________

Address ____________________________

Email ______________________

City: State: Zip Code ___________________

Local Phone I _______________

a

a

VA Educational Benefit

xPlease complete all sections that applyk

Chapter ,7

Chapter ,9

Chapter ,5

Chapter 9676

Chapter 9677

MGI Selective Reserves

VOC Rehab

Montgomery GI Bill

REAP

DEA

Percentage of entitlement _______' Veteranys Spouse6 Dependent

Yes

No

Chapter ,,

Post 9699 GI Bill

Please Note: If you receive less than 977'0 you may have a remaining balance which will need to be paid

Current Major 0 Program of Study ________________________ Declared Minor _______________________

Degree Objective BA6BS

Grad Certificate

Masters

PHD

RN to BN Nursing

Online Only

))Concentration0Option ___________________________________ Anticipated Graduation Date _________________

Term of Enrollment

Summer Session I

Summer Session II

Spring

Fall

__________

__________

__________

__________

Year

Year

Year

Year

Online

Credits

Co ur se

Co ur se

Repeat ed

Transient

O f f ic e U se O n ly

Course

Course

Study

Let t er

Nu m b er

Examplew Y

Check Box

Check Box

Yes or No

Examplew*3*

Examplew ENG

xNeed extra space to list courses us back of formk

Student Health Insurance

Need University Health Insurance Yes

No

Students will be required to complete the Health Insurance Enrollment or Waiver Process each semesterf

<<<< Transient Studies >>>>

Please indicate all approved courses to be taken at another institution xi1e1: a community college: university: college: or study abroadk1 Transient study is limited to active UNCW students1

Signature _________________________________________

Date ______________________________

Please submit a separate form for each termf Changes in course load should be submitted via email to johnson@uncwfedu

xTo ensure timely of processing. please submit this form promptly after registrationk

6@< South College Roadx Wilmington NC T84@>7 9<@596T5><777Fax 9<@596T5>85<