Fillable ADVS Tuition Waiver And Verification Form (Arizona)

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ADVS Tuition Waiver And Verification Form (Arizona)

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The ADVS Tuition Waiver And Verification Form (Arizona) form is 2 pages long and contains:

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  • 14 check-boxes
  • 24 other fields

Country of origin: US
File type: PDF

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The Tuition Waiver program provides eligible Veterans or surviving dependents with a tuition-free
education (up to a Bachelor’s degree) at any Arizona public state university or community college.
Eligibility
The four eligibility requirements of the Tuition Waiver, as outlined in ARS 15-1808, include:
1. Unremarried spouse and/or dependent child (up to age 30) of an Arizona National Guard
member OR member of the United States Armed Forces who was a resident of the state of Arizona
or stationed in Arizona AND who was killed in the line of duty.
2. A current member of the Arizona National Guard who received a Purple Heart Citation aer
09/11/01.
3. A Veteran of the Arizona National Guard who was medically discharged due to an injury or
disability suffered on duty.
4. A person who is a former member of the United States Armed
Forces who received a Purple Heart AND was an Arizona resident
or stationed in Arizona at the time of the injury that resulted in the
Purple Heart AND has a VA disability rating of 50% or more.
For more information and to apply, contact the
Arizona Department of Veterans’ Services at:
(602) 255-3373 or benefits@azdvs.gov
www.azdvs.gov
Arizona Department
of
Veterans’ Services
Tuition Waiver
First: Middle: Last: Jr. / Sr.
F
ull Mailing Address (Must Currently Reside in Arizona):
Date of Birth MM/DD/YYYY:
Contact Number:
Alt. Contact Number:
Email:
Arizona Public University or Community College Desiring to Attend:
Applicants must meet all of t
he eligibility criteria within their tier and submit all applicable documents (I.A.W. ARS 15-1808)
Mail completed application & documentation to:
Arizona Department of Veterans’ Services
3839 N. 3
rd
Street, Suite 209 Phoenix, AZ 85012-1570
Or email to: benefits@azdvs.gov
Verification completed on (For Official Use Only):
___________________________by__________________________________________
Arizona Department of Veterans
’ Services
Tuition Waiver Verification Form
APPLICANT INFORMATION (PLEASE PRINT OR TYPE)
Please check off each document submitted to accompany your application:
For Official Use Only
(Initials of verifier)
Eligibility Tier 1 Applicant- Veterans who are or were a resident of Arizona AND received a Purple Heart AND is rated at least 50%:
DD 214 covering the time a Purple Heart was received
A copy of the Purple Heart Medal documentation
Verification of assignment to an Arizona unit or proof of Arizona residency during the time specified on
the Purple Heart Medal documentation
Verification of at least a 50% disability as determined by the U.S. Department of Veterans Affairs
Eligibility Tier 2 Applicant- Dependent of a Service Member killed in the line of duty:
Relationship to the Deceased Service Member:
Un-remarried Spouse
Child/Stepchild
Check one -->
Casualty Report showing death of the service member
Marriage Certificate (If Dependent Spouse)
Birth Certificate/Adoption Records (If Dependent Child)
Service Member’s Death Certificate or Statement of Killed in Line of Duty
Eligibility Tier 3 Applicant- Current Arizona National Guard Service Members:
(All documentation must show status after September 11, 2001 for National Guard service)
Verification of Arizona National Guard service – Recent orders, LES, Unit Statement of Service, etc.
A copy of the Purple Heart Medal documentation
Eligibility Tier 4 Applicant- Former Arizona N
ational Guard Service Member:
Medical Discharge Documents
Line of Duty Statement
ADVS – Tuition Waiver Verification Form <PIA.JCR> rev. 01/22
© A
rizona De
partme
n
t of Ve
terans’ Services. All rights reserved. www.azdvs.gov
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ADVS Tuition Waiver And Verification Form (Arizona)

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Completed 8 July 2022

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