Veteran Registration Certification Form
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2For Office Use Only:
DND: _____ GIB:_____ Dom: ____ Group____ SS: _____
Cert: _____
Tui: ____ Scanned: _______________________
VETERAN REGISTRATION CERTIFICATION FORM
Round up semester? Yes
No
Term:
Fall
Spring
Summer
Year: ____________
Name___________________________________________________________________Degree Program______________________________________________________
SSN (required)
Student ID#
Address
City, State, Zip
Phone
Email
•
Apply online using VONAPP ( ) if this is your first time using GI Bill benefits. Provide proof of
Before submitting this form, you must:
application or a copy of your Certificate of Eligibility.
•
Be registered for classes.
•
Review your degree to ensure all coursework applies to your degree. Contact your advisor if you have any questions about
course applicability. Only applicable coursework will be certified for VA Benefits.
• Have you attended ANY SCHOOL under the GI Bill before? Y e s
N o
Transfer and Re-Entry Students only:
• Notify the VA of your change of program and place of training using form 22-1995 on the Veterans Online Application website
.
Military Status:
Active Duty
Veteran
Dependent
Spouse
If Active Duty, are you utilizing Tuition Assistance? Yes
No
Branch of Service____________________________
Benefit information [select applicable benefit(s)]:
Chapter 30 – Montgomery GI Bill %
Chapter 1607 – Reserve
VMSDEP (Please check VMSDEP and Chapter 35 if you are
Chapter 31 – Vocational Rehab
utilizing both)
(Voc Rehab Counselor must submit 1905)
Chapter 33 – Post 9/11 GI Bill % ______ ___
MyCAA
Chapter 35 – Dependent/Survivor (Federal
Benefit Only)
Marine GySGT John David Fry Scholarship
Veteran’s SSN:
i
_________________________
_____
Guest Student
Chapter 1606 – Reserve/National Guard
Parent School________________________________
(Must submit Parent letter)
Course Dates
Course name
Class Number
Credit Hours
Updated 11/10/16
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