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Military Tuition Pre-Screen Form
Step
1
of
10
10%
Are you the Veteran, Spouse, or Dependent?
Veteran, Spouse, or Dependent
(Required)
Veteran
Spouse
Dependent
Have you used your tuition benefits before?
Used tuition benefits before
(Required)
Yes
No
Which type benefits do you receive?
Type of benefits received by student
(Required)
Chapter 33 Post 911 GI Bill®
Chapter 35 Dependents Education Assistance
Chapter 30 Montgomery GI Bill®
Chapter 1606 Montgomery GI Bill®
Chapter 31 Veteran Readiness and Employment Service
Chapter 33 Post 911 GI Bill®
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
What is your Name?
First Name
(Required)
Last Name
(Required)
What is your Birthday?
Date of Birth
(Required)
What city you currently live in?
What city you currently live in?
(Required)
What gender do you identify with?
What gender do you identify with?
(Required)
Male
Female
Other
What is your email address?
What is your email address?
(Required)
What is your phone number?
What is your phone number?
(Required)
What is your Social Security Number ?
Social Security Number
