Veterans Data Sheet
To help ensure timely and correct processing of your benefits, please READ and fill out
COMPLETELY. Please PRINT.
Last Name: _____________________ First Name:____________________ Middle Initial: ____
Mailing Address: _______________________________________________________________
(Street or P.O. Box #)
(City)
(State) (Zip Code)
Phone where you can be reached: (______) _________________ SSN: ____________________
Gender (Circle Applicable Response):
Male
Degree Program (Circle Applicable Response): Access
Degree Enrollment: Associate of Arts
Female
Online
Bachelor of Science
Traditional
Bachelor of Arts
Major Area of Study: ______________________________
Email:______________________________________@students.point.edu
SERVICE MEMBER’S BRANCH OF SERVICE (circle one):
Army
Navy USMC
Air Force
Coast Guard National Guard
Reserves
Are you a dependent using transferred Post 9/11 educational benefits? ____yes ____no
VA Educational Benefit: (check applicable benefit)
Chapter 33 (Post 9/11)_____
Chapter 30 (GIBILL) _____
Chapter 35 (DEA)
_____
Chapter 31 (Voc. Rehab)_____
Chapter 1606 (Sel Res)_____
Chapter 1607 (REAP) _____
*Chapter 35 (DEA-Dependents Educational Assistance) Sponsor SSN: ____________________
Tuition Assistance
Assistance
Tuition
Tuition
TuitionAssistance
Assistance(TA)
(TA)isisaaDepartment
Departmentof
ofDefense
Defense(DoD)
(DoD)program.
program.VA
VAdoes
doesnot
notadminister
administerTA.
TA.TA
TArules
rulesvary
varyby
branch
of
service
and
can
even
vary
between
units
depending
on
whether
the
unit
is
active,
reserve,
or
National
by branch of service and can even vary between units depending on whether the unit is active, reserve, or National
Guard. If a student receives education benefits from VA and receives TA benefits from the military, duplication of
benefits may be an issue. The issue might involve VA regulations, DoD regulations, or both since VA and DoD
both have regulations about receiving VA benefits and TA at the same time. It is the student’s responsibility to
SIGNATURE:
__________________________________DATE: ______________
ensure there isn’t a duplication of benefits.
Initial When Read: _____ Do you anticipate using Tuition Assistance? _____Yes _____ No
Signature: ______________________________________ Date: ______________