Fillable In State Tuition Rate Form (Community College of Allegheny County)

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In State Tuition Rate Form (Community College of Allegheny County)

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The In State Tuition Rate Form (Community College of Allegheny County) form is 1 page long and contains:

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  • 22 check-boxes
  • 16 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Community College of Allegheny County

BROWSE COMMUNITY COLLEGE OF ALLEGHENY COUNTY FORMS

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Priority Registration and In-County Tuition Rate Form
_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Please fill out the form completely and return to a Military & Veterans Office.
Name: _________________________________________________
Student ID #: ___________________________
Social Security #: ________________________
Address: _______________________________________________ City/State: _____________________________ Zip Code: ___________
Phone: Home: _________________________ Cell: _________________________ Email: _________________________________________
ELIGIBILITY FOR PRIORITY REGISTRATION AND IN-COUNTY TUITION RATE
Active Duty or Veteran Students
1. Can provide proof of past or current service in the United States Armed Forces, including a Reserve component or National Guard. This also
includes Reserve or National Guard members who completed their obligated service but were never deployed to active duty.
2. If discharged from service must be under conditions other than dishonorable.
Veteran Spouses and Dependents
1. Currently using GI Bill
®
Educational Benefits through the Department of Veteran Affairs or can provide Veteran Sponsor’s DD-214 and copy of marriage
certificate or birth certificate.
Signature: __________________________________________________________________ Date: _______________________________
VA OFFICE USE ONLY:
DD-214 Marriage Certificate or Birth Certificate 
Military ID ___________ UPDATED IN DATATEL BY: ___________
(Reviewed By)
CCAC MILITARY & VETERANS OFFICE
Phone: 412.237.6503
Fax: 412.237.2765
Email: veteransservices@ccac.edu
Required Documents for Request
Active Duty: Current Military ID
Veteran: Military ID Card or DD-214 (Member Copy 4) or Discharge papers from National Guard or Reserves
Spouses & Dependents: Veteran Sponsor’s DD-214 (Member Copy 4) and Marriage Certificate or Birth Certificate
CHECK ALL THAT APPLY
Priority Registration In-County Tuition Rate 
STUDENT TYPE
Active Duty Veteran Reserve National Guard
Dependent Spouse
CAMPUS
Allegheny Boyce
North South
TERM
FALL SPRING
SUMMER YEAR_______
BRANCH OF SERVICE
USAF USA USCG
USMC USN
Reserve National Guard 
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In State Tuition Rate Form (Community College of Allegheny County)

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Completed 26 July 2020

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