Veteran Benefit Enrollment Form



THIS FORM MUST BE COMPLETED EVERY SEMESTER.

Read and process each section carefully -- an incomplete or incorrect submission will result in delays. All documents submitted to the Office of Financial Aid Services must be signed; all e-communications from Financial Aid Services will be sent to student's official Lewis email account.

You must notify our Office of:
  • Changes in student's schedule
  • Changes in program or major
  • Withdrawal, drops or if additional classes have been added

*Required
  
Student Information:
 
*Relationship to Veteran:


  
*Have you received benefits at Lewis University before?
Yes
No
Note: If no, please submit NOBE or DD214
 
*Are you currently on active Duty?
Yes
No


   
*First Name:

*Last Name:

*Student ID:

*Address:

*City:

*State:

*Zip Code:

*Phone Number:

*Grade Level:

*Major:

*Semester for which you
are applying:



Please select your V.A. Benefit Category:


 Post 9/11 G.I. Bill (Chapter 33) *Please submit Certificate of Eligibility

 Montgomery G.I. Bill-Active Duty (Chapter 30)

 Montgomery G.I. Bill-Reserve Duty (Chapter 1606)

 Reserve Educational Assistance Program (Chapter 1607)

 Vocational Rehabilitation (Chapter 31)

 Survivors and Dependants Educational Assistance Program (Chapter 35)
       If selected, enter VA File #

 * By checking this box, I affirm that all information on this form is true and correct to the best of my knowledge. I accept responsibility for any overpayment resulting from inaccurate of false information.



YOU MUST NOTIFY OUR OFFICE OF: (a) Any changes in your schedule, (b) any changes in your program, or (c) withdrawal, dismissal or activation. By Signing below, you are accepting responsibility for any overpayment resulting from inaccurate or false information. You have the legal responsibility of notifying the Lewis University Financial Aid Office of any changes in status or enrollment. Failure to notify this office of any status changes may result in over/under payment and /or delay in receiving your Department of Veteran Affairs Educational Benefits. Note: VA will correct overpayments by subtracting the amount in question from subsequent checks.

*Student Name:

Enter email if you want a copy sent to you: Invalid format.
 
NOTE: All communication from Financial Aid will be sent strictly through your Lewis email account.