Fillable Arizona Department of Veterans Services Tuition Waiver and (Arizona)

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Arizona Department of Veterans Services Tuition Waiver and (Arizona)

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The Arizona Department of Veterans Services Tuition Waiver and (Arizona) form is 1 page long and contains:

  • 1 signature
  • 14 check-boxes
  • 24 other fields

Country of origin: US
File type: PDF

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First
Middle
Last
Jr., Sr.
Full Mailing Address
Date of Birth MO/DD/YYYY:
Contact Number:
Alt. Contact Number:
Email:
School Desiring to Attend:
The following documents are required to be submitted with this application: (As applicable I.A.W. with ARS 15-1808 (D))
Return completed form 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 and 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)
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
Relationship to the Deceased Service Member:
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
Below applies to 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
Below applies to former Arizona National Guard service members:
Medical Discharge Documents
Line of Duty Statement
ADVS
– Tuition Waiver and Verification Form <PIA.NB> rev. 4/20
© A
rizona De
partme
nt of Veterans’ Services. All rights reserved. www.azdvs.gov
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Arizona Department of Veterans Services Tuition Waiver and (Arizona)

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Completed 20 July 2020

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