Request To Use Benefits

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Students using VA Educational Benefits must request to be certified each semester they intend to use benefits. This form acts as a request to send enrollment information to the VA. If you decide not to use benefits after filling out this form, please contact the VA Coordinator to cancel your request.

Last Name *

First Name *

Classification * Graduate Student Undergraduate Student

Semester for which you are requesting benefits Spring 2024 Summer 2024 Fall 2024 Spring 2025

If requesting for prior semester, please list below which semester

Social Security Number *

Student ID Number

Mailing Address *

(City, State, Zip) *

Phone Number *

E-Mail Address *

Major *

Option (If Applicable)

Minor *

Terms & Conditions

As a student receiving VA Benefits, I understand that all courses must be required and applied toward my intended degree including major and minor. If I have not chosen a major and/or minor, I understand that I may only take courses that may be applied towards General Education requirements. I understand that courses that will not apply towards my graduation requirements CANNOT be certified with the VA, and I am responsible for the payment of any such courses. I acknowledge that changes to my schedule, such as withdrawing from a course, may result in overpayment by the VA, and I am responsible for repaying the created debt to NWOSU or the VA. I acknowledge that I must notify that VA Coordinator immediately of any tuition scholarships I receive and any changes to my schedule which includes adding or dropping courses.

Check this box as your electronic signature.

If you are changing your major, you must complete and submit VA Form 22-1995 (Request for Change of Program). You may find this form online through the Department of Veterans Affairs Website or by contacting the VA Coordinator.