School of Education and Human Development Benefits

School of Education and Human Development Benefits

First Name*

Last Name*

Title

UVa Comp ID*

SIS ID*

Dept*

Supervisor Comp ID*

Semester of Enrollment*

Fall

Spring

Summer

Calendar Year of Enrollment*

2022

2023

2024

2025

New Student*

If this is your first time requesting benefits, then select Y for yes

N

Y

Graduate Degree Sought*

PhD

EdD

EdS

MEd

Non-degree

Program degree or emphasis*

Select

# of Total Credits*

First Course Mnemonic*

EDHS

EDIS

EDLF

KINE

First Course Number

# Credits of Course 1

First Course Name

Second Course Mnemonic

EDHS

EDIS

EDLF

KINE

Second Course Number

# Credits of Course 2

Second Course Name

Third Course Mnemonic

EDHS

EDIS

EDLF

KINE

Third Course Number

# Credits of Course 3

Third Course Name

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