Personal Information
Name (Last, First, Middle)
VA Program You Are Eligible For

 
If you are eligible for CH. 35, you must fill out the VA File Number below

VA File Number (Chapter 30, 33, 1606, and 1607 = Student's SSN. Chapter 35 = Veteran's SSN)
Local Address
Street Address
City
State
Zip Code
Phone (Area Code, Prefix, Number)
EMail
School-Related Information
Are you a new student at Miami? Yes No
Benefits received before at Miami
or another institution?
Yes No
If you are eligible for the Post-9/11 GI Bill benefits (CH 33), are you an out-of-state undergraduate student? Yes No N/A
Transfer credits:  (List only credits being applied to Miami degree.)
Class Standing  
Campus  
Degree Objective  
Major
Expected Graduation Date  
I will attend fall 2009 Yes No
Are you attending full time? Yes No
If part time, number of credit hours
I will attend spring 2010 Yes No
Are you attending full time? Yes No
If part time, number of credits
Are you repeating any courses? Yes  No
If yes, which one(s)
The VA will not pay for a repeated course that you have previously received credit for, and the VA will not pay for audited courses that are not a university requirement.
Non Standard Enrollment: Please be aware that if you are taking a course that is not the full length of the semester or you are taking a sprint course, the actual dates of the course will be submitted to the VA which could affect your enrollment status and your pay. For example, if you are taking 9 full semester hours and a 3 credit hour sprint, you will only be paid for full-time hours while the sprint course is in session.
Advance Pay: Advance pay must be requested at least 30 days prior to the start of the fall semester. This payment will be for the months of August and September and will be available in our office on the first day of the term. The next payment will not be issued until November. If you are eligible for break pay you must specifically decline the break pay in order to receive advance pay. Advance pay is only available for the fall semester.
Do you want advance pay? Yes  No
Change in course enrollment at any time may result in the retroactive loss of benefits unless the VA finds mitigating circumstances involved in the change. Loss of benefits may revert back to the first day of class. Courses added during the drop/add period are considered by the VA to begin on the day the course was added, not the first day of semester.
I am aware that changes in my registration may alter the payment the VA will award me. I understand that I will be liable for any overpayment I may receive from the VA.

By typing my name below, I certify that I have read and understand this document, and that all statements are true and complete to the best of my knowledge.

 

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