Fort Hays State University

Class Schedule for Veterans Benefits

Student Information

First Name:

Last Name:

FHSU ID:

Comments (Optional):

Major:

Date of Birth:

VA File #:

VA Chapter #:

Branch of Service:

Are you currently
on Active Duty?

Address:

City:

State:

ZIP:

Phone Number:

Please indicate the number of hours you are taking at FHSU:

Semester
(Gradschool Comp Exam):

Year:

Please give all the Course Names/Course Number/Course Hours you are taking:

Course Name	Course Number	Course Hours
			Delete

If eligible, do you wish
to recieve advance pay?

Email:

(Advance pay allows students to receive the first two monthly payments at the beginning of the semester. The VA determines whether you are eligible. Payment is sent to the school to verify enrollment then forwarded to student.) Authority: This information is solicited through Title 38, U.S. Code. It is considered relevant and necessary to determine entitlement benefits. (P.L./ 93-579) Rev. 12/89 By submitting my e-mail address below as my electronic signature, I certify that the above information is correct. I also certify that the above courses apply toward my degree/certificate program at Fort Hays State University.

Student Information Confirmation

First Name:

Last Name:

FHSU ID:

Comments:

Major:

Date of Birth:

VA File #:

VA Chapter #:

Branch of Service:

Active Duty:

Primary Address:

City:

State:

Zip:

Phone:

Hours taking at FHSU:

Semester (Gradschool Comp Exam):

Year:

Course List:

Advance Pay:

Email: