Application f or T uition A ssistance
South C arolina
for C ertain W ar V eterans’ C hildren
Division o f V eterans’ A ffairs
(Title 5 9-‐111-‐20, 1 976 C ode o f L aws o f S outh C arolina a s a mended)
Check o ne:
[ ] I nitial A pplication
[ ] R esubmitted A pplication
Part O ne: S tudent I nformation
Last N ame:
First N ame:
Middle I nitial:
Social S ecurity N umber:
Date o f B irth:
Address:
City:
State:
Zip C ode:
Number o f Y ears/Months a t c urrent r esidence:
Telephone N umber:
Has s tudent r eceived a H igh S chool D iploma, G ED, o r e quivalent?
1
Relationship b etween V eteran a nd S tudent
: ( Please c hoose o ne)
C hild/Step C hild A dopted C hild ( please g ive d ate o f a doption)
Please l ist t he n ames a nd s ocial s ecurity n umbers o f a ny s iblings w ho h ave b een p reviously a pproved b y t he p rogram t o s peed
processing o f t his a pplication:
1
Please s ubmit o ne o f t he f ollowing w ith t he a pplication: ( 1) a c opy o f t he S tudent’s b irth c ertificate s howing t he V eteran p arent’s f ull n ame, ( 2) t he S tudent’s b irth
certificate w ith p arents’ f ull n ames a nd a c opy o f t he m arriage l icense s howing t he V eteran i s m arried t o o ne o f t he S tudent’s p arents, o r ( 3) a c opy o f t he c ompleted
adoption p aperwork s howing t he S tudent’s a nd V eteran’s f ull n ames.
Part T wo: S chool I nformation
2
Name o f C ollege, U niversity o r T echnical C ollege S tudent w ill a ttend
:
Location o f C ampus:
2
Student m ust h ave b een a ccepted a nd p lan t o a ttend t he s tate s upported i nstitution l isted o n t his a pplication
Part T hree: V eteran I nformation
Last N ame:
First N ame:
Middle I nitial:
Social S ecurity N umber:
VA C laim N umber:
Address:
City:
State:
Zip C ode:
Number o f Y ears/Months a t c urrent r esidence:
Telephone N umber:
Dates o f M ilitary S ervice:
Character o f S ervice:
SOUTH CAROLINA DIVISION OF VETERANS’ AFFAIRS
VA REGIONAL OFFICE
6437
1126
29209
GARNERS FERRY ROAD, SUITE
, COLUMBIA, SOUTH CAROLINA,
803.647.2434
803.647.2312
PHONE
FAX