Cal U GI Bill Application-Spring 2022

Personal Email Address

Cal U email address

First Name

Middle Name

Last Name

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

*Phone number

*PLEASE LEAVE YOUR SSN OR VA FILE NUMBER BLANK IF YOU USED VA BENEFITS AT CAL U IN THE PAST**

Last 4 numbers of your social Security Number

What is your major?

What degree are you seeking?

What term are you requesting benefits for?

How many credits are you enrolled in for the spring term?

What is your anticipated graduation date (mm/yyyy)?

Will you be completing an internship during this term?

Yes

No

Where will be doing your internship?

Are you currently on active duty?

Yes

No

Will you be using TA benefits?

Yes

No

*If you are on active duty & using Tuition Assistance & VA Benefits, you MUST also provide a copy of your TA request form*

Are you currently serving in the National Guard or Reserve component (includes Title 10 or 32 / IRR) ?

Yes

No

Branch of Service:

VA File Number (Chapter 35 - DEA)

If using Chapter 33, what is your percentage of entitlement?

If using Chapter 33, are you using Transfer of Entitlement? (As a dependent of Veteran or Military)

Yes

No

If using Transfer of Entitlement, what is the branch of the Veteran / Military and their rank?

CHAPTER 33: Students that withdraw are responsible for repaying tuition & fee costs to the VA. The ultimate responsibility for the payment of tuition & fees is YOUR responsibility. You will not be allowed to register for or attend any further terms until your financial obligations are current and clear with the Student Accounts/Bursar’s office
CHAPTER 33: If I’m using the Post-9/11 G.I. Bill at the 100% rate, I understand that I am not permitted, by law, to receive scholarships that are solely for tuition & fees, while using the G.I. Bill. If you are, please contact the Director to ensure you are not overpaid.
CHAPTER 33: I understand that if I am completing an internship during this period, my housing rate may be different, based on the zip code, in accordance with Section 107 of the Colmery Act of 2017. Documentation is required if you are completing an internship.

CHAPTER 33 Transfer of Entitlement : Students who are using VA Benefits through the Transfer Program are reminded that housing payments are paid monthly; if living on campus, students should contact the Student Accounts office for semester payment plan

Eligible Veterans, Reservists and Dependents are responsible for requesting VA benefits through the Office of Veteran’s Affairs each time a new schedule is created. Generally, requests are to be made in November and April of each academic year. If you are using benefits in the summer, you are responsible for requesting benefits as soon as you schedule summer courses or when application for enrollment is available.

You will only receive benefits for courses taken that apply to your degree program. I also understand that Cal U is not a Yellow Ribbon school.

You must report any classes dropped or withdrawn from and changes of major IMMEDIATELY to the Office of Veteran’s Affairs.

If I am not a resident of Pennsylvania and am using VA benefits, I must coordinate with the Global Online or Academic Records office to ensure I am coded appropriately for the discounted Global online tuition rate.

Federal Law requires that in order to use VA benefits, you must make academic progress towards graduation. Failure to comply may result in recoupment of funds and benefits to the Department of Veteran’s Affairs.

I understand that it is my responsibility to notify the Military & Veterans Affairs Office of any changes in my scheduled classes. This is not limited to, but includes, add, drops, withdrawals or changes in the number of credits that may differ from those listed above. Any changes in your major or program of study and number of credit hours may affect your pay status. Furthermore, I understand that failure to attend classes and to maintain satisfactory progress may result in reduction or suspension of VA benefits. I understand that if I am registering for classes for the following academic year, I must personally notify the VA Office each semester when I elect to use benefits by completing a new form, each semester. Lastly, federal law prohibits overpayment of 100% between any federal funding to include Tuition Assistance, National Guard FTA when including Post 9/11 GI Bill benefits. No overpayments between those previously listed are to be made or received by the student. It is my responsibility to request benefits each semester.

Student signature: