[5] So Cal22-1995 Complete

[5] So Cal22-1995 Complete - OMB Control No 2900-0074...

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1C. APPLICANT'S TELEPHONE NUMBER (Including Area Code) 5. DIRECT DEPOSIT INFORMATION (Complete this item only if you wish to start direct deposit or your direct deposit information has changed.) Please attach a voided personal check or provide the information in items A through D below. NOTE: Direct Deposit is not available for the Post-Vietnam Era Educational Assistance Program (chapter 32) nor for section 903. A. TYPE OF ACCOUNT 3. HOW WILL YOU TAKE TRAINING? 4C. IF CHANGING SCHOOLS, GIVE NAME AND COMPLETE ADDRESS OF NEW SCHOOL OR TRAINING ESTABLISHMENT YOU ARE PLANNING TO ATTEND (If applicable) PART I - IDENTIFICATION AND PERSONAL INFORMATION OMB Control No. 2900-0074 Respondent Burden: 20 minutes REQUEST FOR CHANGE OF PROGRAM OR PLACE OF TRAINING 1B. MAILING ADDRESS (Complete street address, City, State, and 9-digit ZIP Code) VA DATE STAMP PART III - DIRECT DEPOSIT INFORMATION 4D. NAME AND COMPLETE ADDRESS OF OLD OR CURRENT SCHOOL OR TRAINING ESTABLISHMENT 4A. WHAT EDUCATION, PROFESSIONAL OR VOCATIONAL GOAL ARE YOU WORKING TOWARD? SAVINGS 4B. WHAT IS THE NAME OF THE PROGRAM YOU ARE REQUESTING? PART II - YOUR PROGRAM INFORMATION 1A. NAME OF APPLICANT (First, Middle, Last) NATIONAL ADMISSIONS EXAMS OR NATIONAL EXAMS FOR CREDIT H. CHAPTER 33 (Post-9/11 GI BILL) CHAPTER 30 (Montgomery GI Bill - Active Duty) VA FORM JUL 2012 22-1995 SUPERSEDES VA FORM 22-1995, OCT 2010, WHICH WILL NOT BE USED. CHECKING C. 9 DIGIT ROUTING OR TRANSIT NUMBER D. ACCOUNT NUMBER LICENSING & CERTIFICATION TEST TRANSFER OF ENTITLEMENT PROGRAM B. NAME OF FINANCIAL INSTITUTION 1E. APPLICANT'S E-MAIL ADDRESS 4E. TELL US WHEN AND WHY YOU STOPPED TRAINING AT YOUR PRIOR SCHOOL OR ESTABLISHMENT. CONTINUE IN REMARKS, ITEM 10, OR ON A SEPARATE SHEET IF NECESSARY. DO NOT WRITE IN THIS SPACE 1D. VA FILE NUMBER EVENING 1F. SOCIAL SECURITY OF APPLICANT (For transferability cases, enter the veteran's social security number) DAY FLIGHT TRAINING CHAPTER 32 (Veterans Educational Assistance Program including section 903) CHAPTER 1606 (Montgomery GI Bill- Selected Reserve) B. A. F. TUITION ASSISTANCE TOP-UP (Active Duty Only) D. G. F. C. 2. EDUCATION BENEFIT YOU WANT TO RECEIVE (Only Select One) E. CORRESPONDENCE B. SCHOOL ATTENDANCE APPRENTICESHIP OR ON-THE-JOB TRAINING C. A. COOPERATIVE TRAINING D. CHAPTER 1607 (Reserve Educational Assistance Program) E.
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7. RECENT PERIODS OF SERVICE (PERIODS OF ACTIVE DUTY SINCE YOUR INITIAL PERIOD OF ACTIVE DUTY.) Please complete this section for each period of your active duty since your initial period of active duty if you have not previously reported this information. It will help VA process your claim if you attach a certified copy of "Member 4 Copy" of your DD Form 214 for each period of active service.
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