Veterans Educational Benefits Enrollment

To receive VA Educational Benefits at this College you MUST fill out and sign a "(VEBEF) Veterans Educational Benefits Enrollment" form each semester with our campus Veterans Affairs Office once you've officially registered for your courses.

  • Please print this page, complete the information then turn it into the Veterans Affairs Office

PLEASE PRINT YOUR ANSWERS TO THE QUESTIONS BELOW:

Please select SEMESTER and YEAR that you are REQUESTING VA CERTIFICATION:

  • SPRING:
  • SUMMER:
  • FALL:

YEAR: 20__

VA Educational Benefit CHAPTERS:

(  ) Chapter 30, Montgomery GI Bill
(  ) Chapter 35, Dependents
(  ) Chapter 31, VA Vocational Rehabilitation
(  ) Chapter 1606, Mont., GI Bill (Guard/Reserve)
(  ) Chapter 32, VEAP
(  ) Chapter 1607, REAP
(  ) Chapter 33, Post 9/11 GI Bill
(  ) VRAP Veterans Retraining Assistance Program
(  ) KRS-164 (505/507/515)

  • KY State Tuition Waivers: By checking this block the waiver will be applied ONLY if a copy is on file with JeffersonCTC VA Office.
  • A copy can be attached and we’ll apply and track each semester.

NAME:
Date of Birth:
SOCIAL SECURITY#:
VA FILE#:
ADDRESS:
CITY:
STATE:
ZIP CODE:
PHONE:
STUDENT ID#: 00______________
KCTCS/Jefferson Student Email Address (ONLY):

  • ________________________________@kctcs.edu

TYPE OF DEGREE/PROGRAM PLAN:

(  ) AA = Associates in ARTS
(  ) AS = Associates in SCIENCE
(  ) AAS = Associates in APPLIED Sciences: List AAS Degree Name (i.e.: Culinary Arts, Nursing etc).
(  ) Diploma or Certification in: List Plan name (i.e. HVAC, Auto-Technician, Welding etc).

My Signature Below Indicates:

  1. I understand that it is MY responsibility to report any change that affects my student status (attendance, changes in schedule/credit hours, grades, degree/program plan, mailing address etc) to the JeffersonCTC Office of veterans Affairs and the Department of Veterans Affairs; and that I will be held LIABLE for any overpayment which results from my failure to comply.
  2. I understand I am responsible for paying tuition and fees cost within the deadlines established by JeffersonCTC.
  3. I understand I will ONLY be paid VA Benefits for classes/coursework that is required for my degree/program plan here at JeffersonCTC.
  4. I understand that if I have previously completed a class elsewhere that is the equivalent to a course I’m currently taking, I will not receive VA Benefits for the current class/course.
  5. I have given permission to the JeffersonCTC VA Office to release to the JeffersonCTC Financial Aid Office information necessary to determine eligibility.
  6. The information given is correct and accurate.
SIGNATURE:
DATE: