Columbus State University Veterans Data Sheet

Columbus State University Veterans Data Sheet To help ensure timely and correct processing of your benefits, please READ and fill out COMPLETELY Please PRINT

Last Name: ______First Name: ______Middle Initial: ____

Mailing Address: ______(Street or P.O. Box #) (City) (State) (Zip Code)

Phone where you can be reached: (______) ______SSN: ______

Gender: Male / Female

Undergraduate_____ Graduate_____

ACADEMIC MAJOR: ______MINOR: ______

CSU ID#: 909-

Email:[email protected]

SERVICE MEMBER’S BRANCH OF SERVICE (circle one): Army Navy USMC Air Force Coast Guard National Guard Reserves

DUTY STATUS (circle one):

Active Duty Separated/ETS Retired/Med Board M-Day/Mil Tech AGR

Are you a dependant using transferred Post 9/11 educational benefits? ____yes ____no

*Chapter 35(DEA-Dependents Educational Assistance) Sponsor SSN: ______

VA Educational Benefit: (Please X one only)

Chapter 33 (Post 9/11 or Fry) _____ Chapter 31 (Voc. Rehab) _____ Chapter 30 (Montgomery GI BILL) _____ Chapter 1606 (Sel Res) _____ Chapter 35 (DEA) _____ Chapter 1607 (REAP) _____

Tuition Assistance (For active duty or reserve service members only)

Tuition Assistance (TA) is a Department of Defense (DoD) program. VA does not administer TA. TA rules vary by branch of service and can even vary between units depending on whether the unit is active, reserve, or National Guard. If a student receives education benefits from VA and receives TA benefits from the military, duplication of benefits may be an issue. The issue might involve VA regulations, DoD regulations, or both since VA and DoD both have regulations about receiving VA benefits and TA at the same time.

*It is the student’s responsibility to ensure there isn’t a duplication of benefits.*

Initial When Read: _____ Do you anticipate using Tuition Assistance? _____Yes _____ No

SIGNATURE: ______DATE: ______