VA Benefits Enrollment Form

Please read before completing this form


  1. This form should only be completed if this is your first time using VA benefits at Emory. If you used VA benefits at Emory previously you do not need to complete this form.
  2. The information you list on this form will be entered into the VA system and reconciled with data in their system. Please note that you will be required to enter social security information for yourself (all applicants), and the qualifying veteran (Chapter 35 applicants only). This information will be kept confidential.
  3. Once you have completed this form you must also complete a "VA Certification Request Form" at the link below. You must complete a "VA Certification Request Form" at the beginning of each semester you wish to use your VA benefits at Emory.
  4. You will be required to upload either a copy of your Certificate of Eligibility (COE) or an approval letter/email from your vocational case worker (Chapter 31 applicants only) to complete this form and to receive VA benefits at Emory. If you do not have these documents you cannot complete this form and therefore will not be able to use your VA benefits until you are issued a COE.


To request a copy of your COE please contact the VA at 1-888-442-4551

(We will not be able to certify students who are awaiting the delivery of a COE from the VA, you must have this document)

 

Student Demographic Information

 

This number begins with a "2" and is 7 digits in length (e.g. 2XXXXXX)

 
 
 
 
 
 
 
 
 

Please list the email you would like the VA to use to send you certification confirmations and any other correspondence pertaining to your benefits or enrollment.

 
 
mm/dd/yyyy
 
 

Please select from the menu below

 

VA Education Benefit Information

 

(please select from the menu below)

 

Academic Information

 

Please select from the menu below

 
 

(e.g. Bachelor of Science - Nursing)

If no major has been declared please list "Undecided"

 
Drop your files here