Request for Benefits-fillable

Request for Benefits-fillable - Please check your email...

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
Return East Carolina University Office of Veteran Affairs 101 Whichard Building Greenville, NC 27858 Phone: 252-328-1731 Fax: 252-328-4232 POC: Connie S. Blake regis@ecu.edu blakec@ecu.edu For your convenience you may complete this form for more than one term Full Name: _________________________________________________________________ (first) (middle) (last) Phone: ____________________ *ECU email address: ___________________ @students.ecu.edu Date of Birth: _______________ ECU ID: B_____________ Chapter ____________ Are you the ± Veteran Dependent Indicate the approximate number of hours you plan to attend for each semester you want to receive MGI bill payments. Any necessary adjustments to the original certification will be made after the last day of drop/add; however, if your enrollment changes at any time during the semester, IT IS YOUR RESPONSIBILITY to notify this office in order to avoid a possible overpayment . Spring 2012 _______hrs.** 1 st Summer 2011 _______hrs. 2nd Summer 2011 _______hrs.** * Your ECU email address will be submitted to the VA with your claim so that you can be notified of any activity concerning your certification. Our office also corresponds with you through your ECU email account.
Background image of page 1
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: Please check your email account frequently . Request for Retro terms of _________________ 11 Week 2011 _______hrs **Are you graduating during one of these terms? Fall 2011 _______hrs.** Yes No TERM:_________ Current Degree and Major Program: _____________________________________________ Please indicate your minor or area of concentration : ______________________________ (if REQUIRED by your program of study) Do you want advance pay for fall term? Yes No Our office must receive your request for advance pay no later than 30 business days before the term begins. ***Chapter 33 does not qualify for Advance Pay! I am receiving additional monetary benefits from the following sources: (failure to report such benefits may result in an overpayment of VA benefits) Tuition Assistance (TAPS/ACES)____ Top UP ____ Tuition Only Scholarships ____ Tuition Only Grants ____Other ____ Explain:_______________________________________ Your written or digital signature is required on this form. Unsigned requests will not be processed. Signature: _____________________________________________ Date: _________________...
View Full Document

This note was uploaded on 03/18/2012 for the course ITEC 3290 taught by Professor Dunn during the Spring '12 term at East Carolina University .

Ask a homework question - tutors are online