Important: You must apply for your benefits www.gibill.va.gov in order to start your benefits – this is a one-time application.

This Student Info Form gives USD permission to certify your enrollment – this form is updated annually.

If you have used benefits before at a different school or changed your major, fill out a VA Form 22-1995 (or Form 22-5495 for Ch. 35) before your benefits can be processed. Submit these forms to the VA.

Acknowledgement

By submitting this form, I hereby acknowledge that I must notify Veterans’ Services of all courses I take that do not satisfy a requirement in my degree program.VA will not pay for these classes (extra electives, repeating a passed course, etc.). If I drop, add, or withdrawal from a class I must inform Vet’s office to avoid any over payments or non-payments. Any debts that are created are my responsibility to repay. All benefits, other than Tuition & Fees, will be paid directly to me. Reminder: CH1606, 1607, and 30 must verify their monthly enrollment on WAVE before getting paid. This form expires May 2015.

GI Bill Student Information Form
Check all that apply
Which GI Bill do you use?
Enter your percentage level if using Chapter 33 benefits
Enter your Veteran's Claim/File number if using Chapter 35
Contact your counselor. Counselors must submit VA Form 28-1905.
Please list any other benefits you may use.
Please list any scholarships or employer support you anticipate receiving.
Anticipated Enrollment
mm/yy
I have read and understand all of the above information and have received a copy of the New Student Counseling Form. I hereby acknowledge that I must notify Veterans’ Services of all courses I take that do not satisfy a requirement in my degree program.VA will not pay for these classes (extra electives, repeating a passed course, etc.). If I drop, add, or withdrawal from a class I must inform Vet’s office to avoid any over payments or non-payments. Any debts that are created are my responsibility to repay. All benefits, other than Tuition & Fees, will be paid directly to me.

Return to Veteran’s Services, Office of the Registrar, Belbas 212. Once submitted by the certifying official to the VA, first time education benefits will be processed in 6-12 weeks, recurring benefits may be processed sooner. You will get an automated email from the VA when your credits have been submitted. VA: 888-442-4551. VA Fax: 314-552-9741