Veteran's Benefits Enrollment Form

 

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First Name *

Middle Initial

Last Name *

Street Address *

City *

State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip / Postal Code *

Home Phone Number

Cell Phone Number

Email Address *

Select one that best describes your status *

This is the first time I have attended any University or College using my VA Educational Benefits.

I am a new student transferring credits from another university of college, and I have used my VA Educational Benefits before.

I am returning to Lincoln University after non-attendance for at least one semester (including Summer Semester).

I am a continuing student at Lincoln University, and attended the previous semester.

I have not used my VA Educational Benefit in a least one year.

Are you enrolled in the ROTC Program on campus? *

Yes

No

What level of degree will you be working towards? *

Undergraduate

Graduate

Other (please explain)

Academic Program *

Major *

Has this changed from last year? * - Select -YesNo

Please indicate the type of VA Educational Benefit you are receiving *

Chapter 30 – Montgomery GI Bill

Chapter 31 – Vocational Rehabilitation

Chapter 1606 – Reservist GI Bill

Chapter 1607 – Reservist GI Bill

Chapter 35 – Dependents

Chapter 32 – VEAP

Chapter 33 – Post 9/11

Please indicate term you would like to certify for: *

Fall Semester

Spring Semester

Summer Semester

Number of credits (estimated) *

Leave this field blank