YSU Semester VA Benefit Declaration Form

  • Start
  • (This form is NOT COMPLETE, please read and initial each statement on reverse side, sign and date)
  • Complete

Fill out all appropriate blocks below and initial by each statement.

Include all information pertaining to your address; i.e., house number, street, AND City, State, Zip Code

I wish to use VA education benefits for...(select semester/year below)

Indicate the VA education benefit you are entitled to (contact the Office of Veterans Affairs if unsure)
I plan to use the following DOD/State education benefits this semester:
Subj/Crse#:_____(Ex: Hist 1501)______Cred hrs: 3______Online/On-Campus/ Internship/TA :____(Ex: Online)