Financial Aid

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: (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.


*Required

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

 Vocational Rehabilitation (Chapter 31)
 Survivors and Dependants Educational Assistance Program (Chapter 35)
       *If selected, enter VA File #


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.

 * 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?