PennWest - GI Bill application-Fall 2023

Pennwest Student ID (begins with P, if you do not know it, please enter N/A)

Personal Email Address

PennWest email address

First Name

Middle Name

Last Name

Previous Name

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

*Phone number

Last 4 numbers of your Social Security Number

What degree are you seeking?

What is your major?

Please choose your campus

California

Clarion

Edinboro

Online

What term are you requesting benefits for?

How many credits are you enrolled in for the fall 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 authorization form*

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

Yes

No

Branch of Service:

What GI Bill Chapter are you?

VA File Number (Chapter 35 - DEA only) Please only put the last 4 digits of the dependent SSN number. A member of the Veterans Services department will reach out for the entire SSN number. IF YOU USED BENEFITS PREVIOUSLY AT THIS UNIVERSITY PLEASE TYPE N/A

If using Chapter 33, what is your percentage of entitlement? (please use N/A if using another chapter)

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

Yes

No

N/A

If using Transfer of Entitlement, what is the branch of the Veteran / Military and their rank? (Please use N/A if not using transfer)

If using Chapter 31 VR&E, please provide your PO# and VA Counselor email. (Please choose N/A if not using VR&E)

CHAPTER 35: Please call or email to set up an appointment with the Office of Veteran Affairs to provide the VA file number and documentation of the Veteran - this cannot be submitted through this form due to FERPA policy. calveterans@pennwest.edu or 724-938-4076. If you have used benefits the previous semester, please disregard.
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 PennWest 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.

Please acknowledge that you have read and understand the following:

It is my responsibility to complete this form each semester, and should be submitted as soon as I have scheduled courses for the term.

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.

Yes

No

Student signature: