SDSU:SDSU VA Information Form

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SDSU VA Information Form (Renewal)

Last Name
First Name
Middle Name
Student ID Number
Date of Birth

Current Street Address
City
State
Zip

Permanent Street Address
City
State
Zip

Local Phone Number with Area Code
Permanent Phone Number with Area Code

Summer 2008 Intended Number of Credits
Fall 2008 Intended Number of Credits
Spring 2009 Intended Number of Credits
Major Sought at SDSU
Is This a Change in Major (Yes or NO)
Degree Sought (Undergraduate or Graduate)
Anticipated Graduation Date (Month/Year)


Educational Benefits Program: (Check all that Apply)

	REAP Chapter 1607
	GI Bill (Chapter 30-Prior Service)
	GI Bill (Chapter 1606-Guard/Reserve)
	Kicker
Amount and Months

	Survivors and Dependents DEAP (Chapter 35)
VA Number File (If Known)

	Vocational Rehabilitation (Chapter 31)


Taking Courses from Another School (Yes or No)
If Yes, name school(s) and amount of credits taken, even specify SF Center

Note: For those Taking Courses At Numerous Schools: You will need to notify the SDSU VA office Prior to the beginning of Each Semester of any courses taken from other schools. This will prevent a delay in payment.

Are you repeating any of your courses? (Yes or NO)
If yes, please list course(s)

Note: You must pass the course on the 2nd attempt or you benefits for that class will be revoked.

Summer 2008 (List all courses intended) list: School, Course, Start Date, End Date, Number of Credits for each course

Comments

I certify that I have completed this information form to the best of my knowledge. I am aware that I must notify the VA Office of any changes in this information or my college enrollment status. I understand that any discrepancies in this form will result in a delay of payment or no payment at all. I have been given the SDSU VA Office contacts sheet and will use it to my benefit.

Yes or NO Type Yes if you have read and understand the above paragraph.

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