Last, First, MI * YSU ID Number * Address * Include all information pertaining to your address; i.e., house number, street, AND City, State, Zip Code Phone Number * Non-YSU Email Major * Undergraduate or Graduate * Projected Graduation Date: I wish to use VA education benefits for (list semester/year) * Indicate the VA education benefit you are entitled to (contact the Office of Veterans Affairs if unsure) * CH 1606/1607 Montgomery Reserve – National Guard/Reservists CH 30 Montgomery – Active Duty/ Veterans CH 31 Vocational Rehab - Veterans with disabilities of 30% or higher CH 33 Post 911 - Active Duty/Veterans (Includes Edith Nourse STEM Scholarship) CH 33 Post 911 Transferred Benefits – Dependents CH 35 Dependent Education Assistance (DEA) – Eligible spouses and children Fry Scholarship Other... Indicate the VA education benefit you are entitled to (contact the Office of Veterans Affairs if unsure) Other... Months/Days of VA benefit remaining: (Not Mandatory) I plan to use the following DOD/State education benefits this semester: Tuition Assistance (TA). List branch of service _________________________ (submit approved TA form to the Veterans Resource Center) Ohio National Guard Scholarship – Deadlines to apply: 1 Jul (Fall), 1 Nov (Spring), 1 Apr (Summer) Ohio War Orphan Scholarship – Deadline to apply: May 1 of the previous school year No additional DOD/State education benefits being used this semester Courses to be certified: Subj/Crse#:_____(Ex: Hist 1501)______Cred hrs: 3______Online/On-Campus/ Internship/TA :____(Ex: Online) Leave this field blank CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
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