Veteran Benefit Enrollment Form

GI Bill ® is a registered trademark of the U.S. Department of Veterans Affairs (VA). More information about education benefits offered by VA is available at the official U.S. government Web site at https://www.benefits.va.gov/gibill.

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: (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.

Beginning with terms starting on or after December 17, 2021, if you are using your Post-9/11 GI Bill® benefit at Lewis University, you are required to verify your enrollment at the end of each month to receive your Monthly Housing Allowance (MHA). We want to help you meet this new requirement so you can continue your education without any interruption in benefits. By verifying that you are still enrolled in the same courses or training every month, you help avoid overpayments caused by changes to your training schedule and safeguard your GI Bill entitlement by preventing entitlement charges for training you did not attend. For more information including how to opt in to secure text messaging verification please Click Here.

 * By checking this box, I affirm that I have read and understand the monthly verification process as stated above.



Student Information

*Relationship to Veteran:

*Have you received benefits at Lewis University before?
(Military Benefits: Example – 1606, Chapter 30 Montgomery, Chapter 33 Post 9/11, Chapter 35 Voc Rehab)
 Yes
 No

Note: If no, please submit NOBE (Notice of Basic Eligibility) or DD214
**NOBE is for Chapter 1606 Montgomery G.I. Bill

*Are you currently on active Duty?
** If yes, turn in Active Duty orders to receive Global Active Duty tuition rate
 Yes
 No

*First Name:

*Last Name:

*Student ID: (Example: L12345678)

*Address:

*City:

*State:

*Zip Code:

*Phone Number:

*Grade Level:

*Major:

*Semester for which you are applying:

Please select your V.A. Benefit Category:
(https://www.ebenefits.va.gov/ebenefits/manage/education) or reference VA Certificate of Eligibility (COE)

Please submit Certificate of Eligibility if this is first time applying for benefits (Military Benefits: Example – 1606, Chapter 30 Montgomery, Chapter 33 Post 9/11, Chapter 35)

 Post 9/11 G.I. Bill (Chapter 33)
 Montgomery G.I. Bill-Active Duty (Chapter 30)
 Montgomery G.I. Bill-Reserve Duty (Chapter 1606)
 Reserve Educational Assistance Program (Chapter 1607)

*Time of Benefits Remaining:
Months Days

Note: if you do not know, visit https://www.ebenefits.va.gov (Login -> Manage Tab -> Education -> Enrollment Status -OR- Refer to your last COE sent by the VA).

 Vocational Rehabilitation (Chapter 31)
 Survivors and Dependants Educational Assistance Program (Chapter 35)
*Only if you selected Chapter 31 or Chapter 35 above, enter your VA File #  



We encourage all students to complete the free application for Federal Student Aid. Many students qualify for funds in addition to their Veteran or Military connected Education Benefits. If you have additional questions about this process please contact our School Certifying official Cesar Ceron at Cceron@lewisu.edu.

*Have you completed the Free Application for Federal Student Aid?
 Yes
 No

*Would you like to learn more about our Peer Advisor for Veterans Education (PAVE) Program?
 Yes
 No

*Are you interested in a Work Study Position in our Military Education Resource Center?
 Yes
 No

*Would you like to know more about our Student Veterans Association?
 Yes
 No

 * 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.

*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.

 Do we have your permission to send you a text message?

Security Password (Please type the word ): Wrong Security Password
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