16-17 VA Education Benefit Quarterly Enrollment Survey

An Enrollment Survey will need to be submitted each Quarter for which you wish to receive VA Education Benefits.

Please complete the following survey based on your finalized Study List on the Student Portal.  If you make changes to your study list or your enrollment status changes after you submit this form you must report those changes to the VA Coordinator.

%
Chapter 33 ___% of Eligibility
units
$