Veteran Certification Request/Intake Form

This is your form description. Click here to edit.

Name Name First Last
Please choose one

Please choose one New Certification Request Modify Certification
Phone Phone - ### - ### ####
Email

Confirm Email Address
Student Level

Student Level Undergraduate Graduate
Term
Benefits Chapter Information (Select one)

Benefits Chapter Information (Select one) Chapter 31: Veteran Readiness And Employment Chapter 33: Post 9/11 GI Bill Chapter 30: Montgomery GI Bill Chapter 35: Dependent/Survivors Educational Assistance Chapter 1606: Selected Reserve/National Guard Educational Assistance Chapter 1607: REAP (Reserve Educational Assistance)
Chapter 33 Benefits Percentage
Must be a number less than or equal to 100.
I understand that by signing this form, I am requesting to be certified for the term period noted above. If I decide not to attend the classes, I am responsible for dropping term classes and notifying Enrollment Services of my schedule change (add/drop/change/withdraw). If I do not fulfill this obligation, I am aware my benefits will be delayed. If I drop a class or cancel/modify my term schedule, the VA may require that Furman University or I return the funding that has been provided. I am responsible for all tuition and fees not covered by the VA.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Furman University
Enrollment Services

3300 Poinsett Hwy
Greenville, SC 29613

(864) 294-2030
enroll@furman.edu