Request Form To Receive Va Benefits
ADVERTISEMENT
1Request to Receive VA Benefits
_________________________________________________________________________________________
Please complete the information below and return this form and any other required documents to us by one of the
methods below:
Mail: Brenau University Financial Aid Office, 500 Washington Street SE, Gainesville, GA 30501
Fax: 770.538.4306
Email:
financialaid@brenau.edu
______________________________________________________
P
I
ERSONAL
NFORMATION
Stude t’s Na e (First, Middle, Last):
Social Security Number:
Street Address:
VA File Number (if different from SSN):
City, State, Zip:
Personal Email Address:
Circle One:
School Email Address:
Undergraduate Student
or
Graduate Student
Program of Study (Major):
Phone Number:
Military Branch of Service:
Date of Separation from Military Service:
_____________________________________________________________________
Please check one of the following VA Education Benefit programs that you are eligible for and would like to receive through Brenau
University. To fi d i for atio a out the VA’s edu atio benefit programs go to
Chapter 30 (MGIB)
Chapter 31 (Vocational Rehab) Your VR Counselor must provide a VA Form 28-1905.
Chapter 32 (VEAP)
Chapter 33 (Post- 9/11) Please continue to section 2 of this form regarding the Yellow Ribbon Program.
Chapter 35 (Dependents)
Chapter 1606 (Reservist)
Chapter 1607 (REAP)
For Chapter 33: A limited number of Brenau students (first come, first serve) may apply for the Yellow Ribbon Program, a provision of
the Post-9/11 GI Bill that can provide additional funding for tuition and fees not covered by the Post-9/11 GI Bill. To find out if you
qualify visit:
Please check here if you qualify for the Yellow Ribbon provision of the Post-9/11 GI Bill and would like to apply for Yellow Ribbon.
___________________________________________________________________________________________________
Other eligibility information.
Please check here if you will be receiving Post-9/11 benefits as a dependent of a veteran who is assigning those benefits to you.
Please check here if you are planning to utilize military Tuition Assistance (TA) benefits.
_____________________________________________________________________
Have you received VA Education Benefits at another Institution?
YES. You must complete VA Form 22-1995 Request for Change of Program or Place of Training online at
NO. You must apply for VA education benefits (Except Voc Rehab) online at
_____________________________________________________________________
Please sign and date below.
Signature of Student: _______________________________________________________ Date: ________________________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal