Va Form 22-8873 - Supplemental Information For Change Of Program Or Reenrollment After Unsatisfactory Attendance, Conduct Or Progress

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OMB Approved No. 2900-0358
Respondent Burden: 30 Minutes
SUPPLEMENTAL INFORMATION FOR CHANGE OF PROGRAM OR REENROLLMENT
AFTER UNSATISFACTORY ATTENDANCE, CONDUCT OR PROGRESS
INSTRUCTIONS: Please furnish the information requested in Part I (Item 3) or Part II (Item 4) checked below. Disregard any item
not checked. Also attach any related information that you would like to have considered when VA evaluates your claim. If you need
more space for continuing your answer to an item, use the back of this form. Place your additional information in item 5, Remarks.
Alternately, attach a separate sheet of paper with your additional information to this form.
1 . FIRST-MIDDLE-LAST NAME OF VETERAN OR ELIGIBLE PERSON
2. VA FILE NUMBER OR SOCIAL SECURITY NUMBER
PART I - CHANGE OF PROGRAM
3. YOU HAVE CHANGED YOUR EDUCATIONAL OBJECTIVE (PROGRAM). STATE WHY THIS NEW PROGRAM IS THE RIGHT PROGRAM FOR YOU.
PART II - UNSATISFACTORY ATTENDANCE, CONDUCT OR PROGRESS
4. YOUR PREVIOUS SCHOOL STATED THAT YOUR ATTENDANCE, CONDUCT OR PROGRESS WAS UNSATISFACTORY. IF YOU NEED MORE SPACE FOR
YOUR INFORMATION, USE THE BACK OF THIS FORM OR ATTACH A SEPARATE PIECE OF PAPER.
A. STATE WHY YOU HAD UNSATISFACTORY ATTENDANCE, CONDUCT OR PROGRESS.
B. STATE WHAT STEPS OR PRECAUTIONS YOU HAVE TAKEN TO ENSURE THAT THE UNSATISFACTORY ATTENDANCE, CONDUCT, OR
PROGRESS WILL NOT HAPPEN AGAIN.
C. STATE WHY THIS NEW PROGRAM IS THE RIGHT PROGRAM FOR YOU.
SUPERSEDES VA FORM 22-8873, SEP 2006,
VA FORM
22-8873
WHICH WILL NOT BE USED.
AUG 2009

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