Veteran/Dependent Enrollment Information
Post 09/11 (Veteran or Dependent)
Dependent of a deceased, 100% VA disabled, POW, or MIA Veteran (due to
service connected disability/death)
Reservist or Guard Member who HAS NOT deployed
Reservist or Guard Member who HAS deployed at least 90 consecutive days
Name Social Security No.
City State Zip
Contact Phone # ( ) _- _ UCO E-mail Address
Title of Major(s)
(Example: BS – Kinesiology – Fitness Mgmt; If Forensic Science Major list 1
Title of Minor(s) (if applicable):
What is your classification: Freshman
Sophomore Junior Senior Graduate
**Please answer the questions that follow by checking the appropriate box.
Will you be graduating this semester?
Will you be receiving a tuition waiver?
Note: In order to get this form signed to receive your VA benefits, you must meet with your UCO Academic Advisor
every semester for an updated degree evaluation. Appointments with Academic Advisors can be made online at
https://myadvisor.uco.edu or via phone at (405) 974-2727.
Please check the appropriate box based on your answer to the following statement:
“I have seen my Academic Advisor for an updated degree evaluation for the semester I am requesting VA benefits.”
This form must be filled out each semester you wish to use your veteran education benefits, or if adding courses to current semester
after initial form was submitted.
TO INSURE YOUR MONTHLY STIPENDS ARRIVE ON TIME, PLEASE SUBMIT THIS FORM 30 - 45 DAYS BEFORE
THE SEMESTER BEGINS, PREFERABLY DURING PRIORTY ENROLLMENT.