Veterans Information Sheet

By submitting this form, I understand the following:

  • All coursework must be required for my approved degree in order to receive VA benefits; electives may not be eligible for benefits.
  • I can only be paid for repeated courses when the initial grade received was an 'F'; VA will not pay for repeats of 'D' grades unless the course requires a 'C' to progress (i.e. MATH 141).
  • No payment can be received for audited courses.
  • In the case of a failing grade, the instructor will be contacted to verify the last date of attendance
  • Chapters 30, 1606 and 1607 recipients must verify enrollment monthly (online via WAVE or by phone).
  • I must notify the Veterans Services Office of any changes in my enrollment for this semester and that such changes could impace my level of educational benefits, including potential repayments of benefits (tuition, monthly payment, etc.).
  • I consent to release to the US Department of Veterans Affairs all of the student education records maintained by the University of Wisconsin-Whitewater, including, but not limited to, my Social Security Number.

 PDF Version of Form

Identification

AND

AND

Student Information

@uww.edu

Please provide your UW-Whitewater email address only. 

VA Education Benefit Information: (Check One)

Montgomery GI Bill (Chapter 30) Vocational Rehabilitation (Chapter 31)
Currently on Active Duty Post 9/11 GI Bill (Chapter 33) % of Benefit
Montgomery GI Bill – Selective Reserve (Chapter 1606) Reserves or National Guard REAP (Chapter 1607) – Activated Reserves or National Guard Under Title 10 Contingency Operations
Post 9/11 Dependent Transfer (Chapter 33) Dependent (Chapter 35) VA File #
Term of enrollment

Yes No

If you have any questions about this form or your educational benefits, contact the Veterans Services Office in the Registrar's Office, Roseman Building 2032 or 262-472-1570.