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 Affiliation or
Campus Location of your Advisor:		 Springfield/Monett
  Ft. Wood/St. Robert/Rolla/Lebanon
  Cabool/Ava/Licking/Thayer

Please select your responses:
Ch 30 (Montgomery G.I. Bill – Active Duty)
Ch 31 (Disabled Veterans/Vocational Rehabilitation)
Ch 33 (Post 9/11 GI Bill)
Ch 33 (Transferred from a Veteran Parent/Spouse)
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 and CH 1607 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
Chapter 33 Transferred Benefits
Branch: Army
Navy
Air Force
Marines
Coast Guard
Other (Students using transferred or dependent benefits)
Tuition Assistance (Military)

Yes No
Explain:

Please Note: Military Tuition Assistance is requested separately. For questions contact Raeleen Ziegler at the Ft. Wood campus: 573-329-4400
Type of Training: Undergraduate
Graduate
LE Academy

 
School: Day School
CGCS (Evening/Online Programs/Graduate Programs)

 
Degree/Major:
Major:
Credit hours to be certified this semester:
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

 
Will you (or your spouse if using transferred benefits) be on active duty anytime during this enrollment period?
Yes No
If yes, please give dates of active duty period:

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 Certificate of Eligibility 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 dollar amount of G.I. Bill Educational benefits:
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, and 1607)
  • If I have questions regarding my VA eligibility or payment amounts, I should call the DVA at 1-888-4424551.
  • I will submit a Drury University Veterans Certification Request each semester I wish to be certified at Drury University