California State University, Chico
Office of Veterans’ Affairs
Intersession / Summer Request for Benefits
Name ______________________________________________ Student ID #_____________________
YOUR CURRENT ADDRESS: If Change of address, Check Here:
Street ____________________________________
City ________________ State ___ Zip _______ Phone ( )-__________________________
Wildcat Email: _________________________________________________ @mail.csuchico.edu
(You VA@csuchico.edu) must submit your request using your Wildcat Email to:
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Current Objective: BA/BS 2
nd
BA/BS MA/MS Teaching Cred.
Class Level: Fr So Jr Sr Post-Bacc Expected Graduation Term: ____________
Major: _______________________________________ If Change of major, Check Here
IMPORTANT NOTICE: Certification beyond this semester is NOT automatic. It is your responsibility
to ensure that your benefits continue. Allow VA 4-6 weeks to process any claim.
I request VA educational benefits for: Year _______
Intersession Summer
I am enrolled for the following courses:
Course Title Units Start Date End Date
_________ ____________________________ ____ _______ _________
_________ ____________________________ ____ _______ _________
_________ ____________________________ ____ _______ _________
I understand that I will only receive benefits for courses that are required to complete my approved
academic program. I agree that I will notify the Office of Veterans’ Affairs of any and all changes
to my class schedule within two working days of the change or I may experience payment delays.
Submitting this request with my Wildcat Email constitutes my signed agreement with the
information as listed on this request and is considered appropriate for processing my request.
