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Contact:
Office of Financial Aid
Office: (417) 873-7312
Toll Free: 1(800) 922-2274
Fax: (417) 873-6909
fa@drury.edu

Veterans Certification Request
The completion of this form authorizes Drury University Veterans affairs Office to provide required information and to certify your enrollment at Drury University for a specified semester to the U.S. Department of Veterans Affairs (DVA). This form must be submitted each semester you plan to attend Drury University and receive VA benefits.

Last Name:
First Name:
Middle Initial:
SSN

Address:
City:
State:
Zip Code:
Phone (Home):
Phone (Cell/Business):
Student Number:
E-mail:
Campus:	Springfield/Main Campus
	Ft. Wood
	Cabool/Ava

Please select your responses:
Ch 30 (Montgomery G.I. Bill – Active Duty)
Ch 31 (Disabled Veterans/Vocational Rehabilitation)
Ch 35 (Survivors/and Dependents Education Assistance Program)
Ch 1606 (Montgomery G.I. Bill - Reserve/National Guard)
Ch 1607 (REAP-Reserve/Guard called to active duty after 9-11-01)

Please Note: CH 30 and CH 1606 must report school attendance to the DVA at the end of each month in order to receive payment. You may report by phone: 1-877-823-2378 or online: http://www.gibill.va.gov.

Status:	Active Duty Guard Drilling Guard Active Duty Reserve Drilling Reserve Retired Discharged Inactive Reserve Chapter 35 Dependent
Branch:	Army Navy Air Force Marines Coast Guard
Tuition Assistance (Military)	Yes No Explain:
Type of Training:	Undergraduate Graduate LE Academy

School:	Day School Night School

Degree/Major:	Major:
Credit Hours :
Application Status:	New Applicant (Applying for VA benefits for the first time) Continuing Student(Have received benefits before at Drury University) Transfer, From (Transferring from another institution where I used VA benefits)

Semester / Year:	Summer I Summer II Summer III Fall Spring

Have you changed your degree program/major and/or place of training/school since your last certification request? Yes No Explain:

Do you have a current DD 214 or NOBE (Notice of Basic Eligibility/Guard and Reserves) on file in the Drury University VA office? Yes No
Comments:

The following may affect the monthly dollar amount of G.I. Bill Educational benefit check: dropping or adding classes, enrolling in an unauthorized repeat of a class, enrolling in classes that do not fulfill general education or program requirements in your degree . Please read the following carefully and submit the form:

I must attend class and make satisfactory academic progress
It is my responsibility to notify the Drury University Veteran Affairs Representative if I make changes in my class load.
I will provide information to the Office of Financial Aid regarding my veteran status, category and monthly rate of pay.
I will “verify” my attendance each month @ (1-877-823-2378) or www.gi/bill/gov/wave/ (applies to: Chapters 30, 1606)
I will submit a Drury University Veterans Certification Request each semester I wish to be certified at Drury University